What is Plantar Fasciitis and How Do I Treat It ?
A Complete Guide to Understanding and Resolving Plantar Fasciitis Heel Pain
If you suffer from sharp, throbbing or aching heel pain with your first steps each morning, or while walking throughout the day, you may have a condition called Plantar Fasciitis (also known as Plantar Fasciosis). This guide will help you understand the symptoms and causes of Plantar Fasciitis, identify helpful pain-relieving techniques, and discover effective treatment options.
What is Plantar Fasciitis?
Plantar Fasciitis (pronounced plantar fash-ee-eye-tis) can be literally translated as “foot inflammation, and is the result of strain, inflammation or damage to one of the most important ligaments in the foot – the plantar fascia.
The plantar fascia ligament is made of flexible, fibrous tissue that stretches from the heel bone to the ball of the foot, forming an elastic arch that distributes and absorbs the daily impact of walking, standing, running and jumping.
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Healthy feet are marvels of engineering and artfully bear the brunt of 5,000-10,000 steps that the average adult takes each day as estimated in one study published in Medicine & Science in Sports & Injury in 2010. However, in the case of injury, overuse, or strain, the plantar fascia ligament may sustain damage in the form of small tears or micro-injuries. In an effort to support the damaged arch, the body sends additional substances to the injured area which, over time, can cause jagged bone spurs to form on the heel or weakening of the fibers. These pointed or shelf-shaped protrusions dig into the fatty pad of your heel with each step you take, causing additional heel pain. Not all plantar fasciitis is due to bone spurs, though. It is considered a chronic degenerative disorder with disorganized collagen, excess or lack of vessel growth, and lack of inflammation. It is believed that the altered blood flow is responsible for local nutritional deficits that impairs healing.
It’s helpful to note that some medical professionals including Dr. Kendrick Allen Whitney, DPM, prefer to use the term Plantar Fasciosis or Plantar Fasciopathy instead of “Plantar Fasciitis”. This is because some studies, including one published by the Journal of the American Podiatric Medical Association in 2003, indicate that degeneration of the plantar fascia ligament is more commonly responsible for the condition rather than inflammation.
In cases of both inflammation and degeneration of the plantar fascia, this painful condition is progressive: In other words, if left untreated, the combination of impact and movement, a damaged fascia, and the formation of bone spurs can become debilitating to the sufferer. Fortunately, there are excellent, non-invasive treatment options that can successfully resolve most cases of Plantar Fasciitis.
What Are the Symptoms of Plantar Fasciitis?
Because Plantar Fasciitis affects the soft tissues in the foot, it cannot be detected with an X-ray. In most cases, this condition is diagnosed based on health history and symptoms; however, your doctor may still recommend X-rays to rule out the possibility of a stress fracture, particularly if your symptoms came on very suddenly.
If you are experiencing one or more of the following symptoms, you may be suffering from Plantar Fasciitis:
- Pain that is the worst first thing in the morning, or after a long period of rest
- Aching, sharp, or burning pain in the sole of your foot, often localized in the heel area.
- Heel pain that may build gradually, or become apparent suddenly
- Pain that may decrease somewhat as you begin moving around, only to return later in the day.
- Heel pain that coincides with obesity or rapid weight gain
- Foot pain that has lasted for more than a few days, or which you experience periodically over the course of months or years.
- Pain in just one foot (although it is possible to have Plantar Fasciitis in both feet).
- Swelling, redness, or warmth in the heel area.
- Limping and difficulty standing on the affected foot.
Whether you are experiencing heel pain for the first time, or as a chronic struggle, it’s important to seek treatment as quickly as possible. Most cases of Plantar Fasciitis can be resolved at home with conservative treatments; however, early intervention greatly improves the chances of a speedy recovery.
Plantar Fasciitis Causes and Risk Factors
The American Academy of Family Physicians cites Plantar Fasciitis as the the number one cause of heel pain, affecting both children and adults, men and women, and active and sedentary individuals. Without proper treatment, symptoms of Plantar Fasciitis can reoccur and worsen over the course of months and years.
Typically, Plantar Fasciitis results from a combination of causes and risk factors, including the following:
Pronation or an Irregular Gait
Pronation, a gait abnormality that causes the foot to roll outward excessively while walking is strongly associated with Plantar Fasciitis, since it prevents the arch from distributing weight evenly from the heel to ball of the foot. Supination, a less common condition in which the foot rolls inward excessively, can also cause Plantar Fasciitis.
Failure to give your feet the rest they need between exercise sessions or long periods of standing can flatten and strain the arch over time. Working conditions that involve long hours spent standing or lifting heavy objects are especially high risk.
Arches that are too high or too flat are at greater risk for Plantar Fasciitis, since they are less optimized to bear the weight of impact and standing.
Weak or Tight Surrounding Tissue
Weak calf muscles, reduced ankle mobility, or tightness in the Achilles tendon at the back of the heel can hamper a normal gait and lead to arch injury.
Obesity or Rapid Weight Gain
Obesity is strongly associated with Plantar Fasciitis. Rapid weight gain, including weight gain from pregnancy, can place significantly more strain on the arch of the foot, resulting in damage and tearing.
The normal aging process can result in a loss of soft-tissue elasticity and may lead to a rigid–and more injury prone–plantar fascia.
Ill-Fitting or Old Footwear
Shoes that don’t fit right, or don’t provide proper cushioning and arch support, can play a significant role in plantar fasciitis. Running shoes should be retired as the soles wear down and the cushioning flattens, to protect the integrity of your arches.
Injury or Trauma
Injury to the foot or heel can lead to Plantar Fasciitis if the arch or surrounding tissue becomes damaged. In some cases, spraining or otherwise injuring one foot can lead to Plantar Fasciitis in the other foot, which absorbs extra strain and impact while the injured foot heals.
Is There a Cure for Plantar Fasciitis?
While the majority of Plantar Fasciitis cases can be successfully resolved with the treatments outlined below, everyone is different. For some individuals, the pain of Plantar Fasciitis can be chronic, stubborn, and very frustrating.
Most doctors recommend sticking to a regimen of consistent, conservative treatments for at least one year, since the healing process can take several months. However, in cases of chronic Plantar Fasciitis that does not respond to conservative remedies, more invasive medical treatments may be necessary and helpful.
Effective Conservative Treatments for Plantar Fasciitis
More than 90% of Plantar Fasciitis cases respond to conservative treatments. The key is consistency and some degree of patience. Remember, Plantar Fasciitis is the result of degeneration or inflammation of the arch: strengthening, healing, and allowing the body to regenerate the arch will take time.
Rest is key to any injury, and Plantar Fasciitis is no exception. Sit or lie down several times throughout the day, to take the pressure of your body’s weight off your plantar fascia ligament. If you spend a lot of time on your feet at work, spend your breaks sitting down. And make sure to schedule downtime and rest between exercise sessions and physical activity, Rest allows your Plantar Fascia to heal micro-injuries and “bounce back” over time.
Apply an ice pack to your heel and any areas of redness and inflammation for twenty minutes, twice a day, to manage pain and promote healing.
A strong, flexible arch is significantly more able to bear the weight of walking, running, and jumping without injury. Simple stretches, performed once or twice a day for 10-15 minutes can break up adhesions on the arch, improve circulation to any tears or micro-injuries, strengthen the surrounding muscles and ligaments, and improve flexibility.
Orthotic inserts like Heel Seats designed especially for Plantar Fasciitis sufferers, add cushioning and support to the arch of the foot. These specialized orthotics also lift the arch to an optimal level for absorbing impact and distributing weight. Orthotics also relieve pain by taking the pressure off heel spurs and cushioning the heel of the foot. Other products that can support a compromised arch include night splints, heel wraps, and taping.
Orthotic Heel Seats for Plantar Fasciitis
The American Podiatric Society gives its stamp of approval to Heel Seats, clinically-tested Plantar Fasciitis orthotic inserts that are proven to deliver excellent results in more than nine out of ten cases. Thirty years of design research have culminated in a safe, durable product which has helped thousands of people suffering from heel pain, Plantar Fasciitis and bone spurs.
Most people experience meaningful relief within 30 days of using this effective aid. Heel Seats add a dense, protective layer to the fatty pad of your heel and apply therapeutic acupressure to the heel bone and midsole, immediately reducing stress on the bone and ligament. In this cushioned environment, the heel can begin to recover naturally.
The intelligent design of these inserts offers a unique combination of fast pain relief and long-term healing support. Hundreds of Heel Seats testimonials and reviews attest to the power of these orthotic inserts’ power to change lives.
In your search for a solution to your heel pain, you’ll find other orthotics priced in the hundreds of dollars. Not only are Heel Seats priced at about the cost of a lunch out on the town, but they are backed by a 100% satisfaction guarantee. Claim the health and freedom of being able to stand, walk and run every day, pain-free.
More Treatment Options for Chronic Plantar Fasciitis
For stubborn or chronic cases of Plantar Fasciitis that resist conservative treatments, it may be necessary and advisable to explore effective medical treatments or surgery, including the following:
Extracorporeal Shockwave Therapy (ESWT):
ESWT is a nonsurgical treatment option for Plantar Fasciitis that uses shock waves to treat the damaged arch. While it can be somewhat painful, several studies have concluded it seems to be effective for treating stubborn cases of Plantar Fasciitis without surgery.
Radiation therapy is a nonsurgical treatment that uses small doses of radiation to target the damaged tissue in the arch. This therapy is reasonably priced, has minimal side effects and risks, and is not painful. One 2012 study found that 80 percent of patients experienced complete pain relief following the therapy, and 64 percent were still pain-free 48 weeks later.
Intracorporeal Pneumatic Shock Therapy (IPST):
This new therapy is similar to ESWT and applies shock waves to heel spurs. It requires local anesthesia and is less painful than ESWT. A study by Dr. Dogramaci, MD, showed a 92% success rate in pain reduction reported by patients.
Plantar Fasciitis Surgery
Surgery to remove a portion of the damaged plantar fascia ligament, release part of the plantar fascia, or eliminate heel bone spurs should be considered a last option because of its cost and potential complications. However, many types of surgery have high success rates and good long-term outcomes.
More Plantar Fasciitis Topics to Explore
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- Barrett, S., & O’Malley, R. (1999). Plantar Fasciitis and Other Causes of Heel Pain. Am Fam Physician. Retrieved from https://www.aafp.org/afp/1999/0415/p2200.html
- Bassett, D. R., Wyatt, H. R., Thompson, H., Peters, J. C., & Hill, J. O. (2010). Pedometer-Measured Physical Activity and Health Behaviors in U.S. Adults. Medicine & Science in Sports & Exercise, 42(10), 1819–1825. doi: 10.1249/mss.0b013e3181dc2e54
- Dogramaci, Y., Kalaci, A., Emir, A., Yanat, A. N., & Gökçe, A. (2009). Intracorporeal pneumatic shock application for the treatment of chronic plantar fasciitis: a randomized, double blind prospective clinical trial. Archives of Orthopaedic and Trauma Surgery, 130(4), 541–546. doi: 10.1007/s00402-009-0947-0
- Lemont, H., Ammirati, K. M., & Usen, N. (2003). Plantar Fasciitis. Journal of the American Podiatric Medical Association, 93(3), 234–237. doi: 10.7547/87507315-93-3-234
- Lou J, Wang S, Liu S, Xing G. Effectiveness of Extracorporeal Shock Wave Therapy Without Local Anesthesia in Patients With Recalcitrant Plantar Fasciitis: A Meta-Analysis of Randomized Controlled Trials. Am J Phys Med Rehabil. 2016 Dec. PubMed #27977431.
- Science Daily (2012) https://www.sciencedaily.com/releases/2012/07/120727102446.htm
- Whitney, K.A. (2018). Plantar Fasciosis https://www.merckmanuals.com/professional/musculoskeletal-and-connective-tissue-disorders/foot-and-ankle-disorders/plantar-fasciosis