Plantar Fasciitis - The gift that keeps on giving!

Hey guys!  

Let’s finish out our heel pain series with the star of the show, Plantar Fasciitis. Plantar fasciitis is no fun, and I know this from personal experience (ughhhh!)

It was certainly one of the top three conditions I treated in clinical practice. 

Let’s get into what it is!

What is plantar fasciitis?

The plantar fascia is a ligament that runs along the bottom of the foot from the heel bone to the base of the toes. It can become inflamed or injured at the point where it connects to the heel. We typically describe plantar fasciitis pain as “start-up pain”. That is, when you first stand and get going, there is a deep burning or tearing type of pain in the bottom of the heel, which usually improves after a few steps. In severe injuries, the pain can be present constantly. 

(Picture credit: OrthoInfo – American Academy of Orthopedic Surgeons)

What are the causes and risk factors of plantar fasciitis?

1. Overuse

Impact sports such as basketball and running can cause overuse to your plantar fascia. Also, you may experience some pain when starting new activities.

2. Injury

Injuries from accidents are unavoidable. It is possible to tear your plantar fascia when you fall or jump.

3. Poor Shoe Wear Use

The shoes you wear are incredibly important for your health. Picking unsupportive shoes can cause to added strain on your plantar fascia.

4. Pregnancy or Being Overweight

Pregnancy is a temporary situation that changes how your body carries weight. In a short period, your feet must support an increase of weight and a change in your center of gravity. All these changes significantly increase the stress on your plantar fascia. If you are overweight, you can also add stress to your feet and plantar fascia with longer term impact.

5. Achilles Tendon Tightness

General tightness through your feet can lead to stress and strain in other parts of the foot. Achilles tendon tightness can put more load on the plantar fascia, causing pain.

6. High Arches

High arches are likely congenital, but that doesn’t mean it cannot affect your plantar fascia. Your high arches cause the ligaments and tendons to support your feet in less-than-ideal ways. Those high arches can inflame the plantar fascia.

How do I treat my plantar fasciitis at home?

The average case of plantar fasciitis can last from 6 to 9 months!

The plantar fascia ligament plays an important role in maintaining the arch and is incredibly important in how the foot functions when you stand and walk. Understanding this helps guide our management of the condition.

Stretching

1. Plantar fascia specific stretching and Achilles stretching: Check out my Achilles tendon stretch video on IG (@drevamd) to learn how to stretch out your plantar fascia and Achilles tendon. This is by far the best way to manage your plantar fasciitis. You should perform these stretches several times a day (3 to 5 times) for just a few minutes just before standing.

Achilles Tendon Stretch Video (Instagram Link) 

Arch Support

2. The Arch Support - The plantar fascia ligament helps hold up the arch, so to help relieve it, you need arch support pretty much ALL the time while you are managing the condition. A good pair of over-the-counter insoles (I like the brand Powerstep®) can be added to your shoes. Be sure to not get the soft gel insoles that just collapse once you are standing. For indoors, try a pair of easy to slip on slides that support your arch (like a Birkenstock®). In most cases, an expensive pair of custom orthotics are not needed.

Proper Shoes

3. Shoe wear changes—Ditch those super flat sandals and shoes! They are not doing anything to support your arches. Also, try swapping out your running shoes if they have over 450 miles on them.

Avoid Activities that Trigger It

4. Activity modification–Minimize the activity that caused it to flare it. Try activities such as swimming, cycling, or weight training to minimize the forces on your heels. You may also need to improve your running gait to ensure you are not putting too much pressure on your heels.

When do I see a doctor for my plantar fasciitis?

If you’ve tried the at-home remedies for several weeks or are having severe pain, it is time to see your Orthopedic doctor. He or she may offer: 

Physical therapy

Shockwave therapy 

Cortisone injections 

Other types of injections

Very, very rarely surgery

Remember, given enough time, most cases will resolve without significant intervention!

Hope this helps!

XOXOXO 

Dr. Eva