What is plantar fasciitis?
Plantar fasciitis is inflammation of the plantar fascia of the foot, a ligament that joins the heel bone with the proximal phalanges and extends and contracts with each step, like a rubber band.
The plantar fascia is a very wide, thick tissue due to the enormous amount of pressure and resistance it must support.
Inflammation of this ligament presents with pain in the heel area, one of the most common causes of pain in this area.
People at higher risk of this issue are athletes, especially amateurs.
- Sports with repetitive movements
- Conditions such as arthritis or diabetes
- Improper footwear
- Flat feet
- Advanced age
- Hormonal changes
What does the condition look like?
Overuse of the plantar fascia ends up causing micro-traumas to the tissue. Repeated tiny tears lead to inflammation in the ligament, which causes the heel pain.
In other words, it’s a chronic issue, as it doesn’t appear overnight but rather as a result of repeated injuries.
Causes of plantar fasciitis
Injury of the fascia can happen for many different reasons; it has many variable factors including environmental, postural, and genetic.
There are also factors that seriously aggravate the pain, like using improper footwear, bad posture, overuse of the area, inflexibility in related muscles, and overpronation.
Repetitive physical activity
Excessive exercise is the main cause of plantar fasciitis.
Physical activity like running or jumping for long periods of time overload the ligament, unable to take so much wear and tear. In addition, changes in exercise plans without doing them gradually can cause more severe tears and thus worse pain.
Runners, soccer players, and people who play badminton or tennis are most at risk.
Anatomy of the foot
There are several anatomical structures that play a role in any overloading of the plantar fascia.
The Achilles tendon is a ligament that connects the gastrocnemius muscles, commonly known as the calves, and the soleus muscles, to the heel bone. A retraction of the Achilles tendon triggers an increase in pressure on the heel bone, with the resultant increase of pressure on the plantar fascia.
Another factor to keep in mind in the anatomical structure is the foot strike, or in other words, how the foot touches the ground. Flat feet or feet with a tendency to overpronate stretch the plantar fascia more, thus increasing the risk of tearing due to the extra pressure on the tissue.
Arthritis and diabetes are considered risk factors for plantar fasciitis, as both may cause inflammation of the tendons.
People of advanced age tend to present with this pain as a result of one of these two conditions.
Type of shoe
Often times, people don’t wear shoes that fit right. Or the sole is unsupportive or is poor at effectively distributing the weight.
Constant use of improper footwear ends up irritating the plantar fascia, as well as causing other foot problems. High heels are a big no-no when it comes to plantar fasciitis.
Characteristics of the pain
- Worse in the mornings
- Stabbing or burning pain
The pain tends to increase in the mornings because the foot is kept rigid overnight, and decreases over the course of the day as it stretches and the tissue warms up.
In some cases the pain becomes unbearable and even affects the phalanges, impeding movements like moving the toes up and down.
Plantar fasciitis is often associated with the existence of a bone spur, though it is not a determining factor.
When the plantar fascia is lengthened over time or is not treated correctly, the person may see changes in their gait, leading to problems and pain the knees, back, or neck.
Treating plantar fasciitis
- Physical therapy
- Proper footwear
- Functional taping
During treatment, resting from exercise is essential since it aggravates the problem, but stretching of the soleus and gastrocnemius should be done throughout the day.
Some professionals recommend using a split overnight or while resting to keep the fascia stretched.
Last resort treatments include shockwave therapy and surgery, the latter being only for serious, chronic plantar fasciitis.
Recovery time varies among patients.