Plantar Fasciitis

What is Plantar Fasciitis?

Plantar fasciitis is a chronic foot injury that is common in athletes that perform repetitive flexion/dorsiflexion of the toes. The plantar fascia is the tough, fibrous band of tissue that connects the heel bone to the base of the toes. With each step, the plantar fascia is stretched, and the arch flattens to absorb the heels impact on the ground. Because the plantar fascia is not very flexible, repetitive stretching can result in small tears.

The classic sign of plantar fasciitis is heel pain during the first steps of the day. That plantar fascia shortens overnight resulting in pain when it is first stretched. Pain associated with recent weight gain or a sudden change in exercise pattern is also a sign of plantar fasciitis. While heel spurs can be a sign of plantar fasciitis, with about half of all patients with plantar fasciitis having spurs, they are typically not the cause.

Individuals with flat feet, high arches, and/or tight achilles tendons may be predisposed to plantar fasciitis. Rapid weight gain, a rapid increase in the intensity or duration of activity, shoes with improper/poor cushioning, and/or prolonged standing can increase the likelihood of plantar fasciitis.

Treatment of Plantar Fasciitis

Perhaps the most important treatment for plantar fasciitis is to avoid activities that irritate the condition, including walking barefoot on hard surfaces. The use of footwear with proper arch support is also important. Other treatments include weight loss and/or stretching of the achilles tendon and/or plantar fascia.

Taping the heel and arch may help to reduce pain, as can medial longitudinal arch supports. Massaging the fascia by rolling the foot over a 3-4 inch diameter tube can also be an effective treatment.

As directed by a physician, non-steroidal anti-inflammatory drugs (NSAIDS) can be used in conjunction with these other treatments for a period of 2-4 weeks. Strengthening exercises include crumpling a hand towel with the toes or pulling a weighted towel across the floor with your toes. Following exercise, place a cold pack or ice bag on the heel at the most tender spot. Remember, ice shouldn’t be applied for longer than 15-20 minutes without a break.

Alphabetical Index of Injuries: