Plantar fasciitis, one of the most common causes of foot and heel pain, is a painful burning feeling in the sole of the foot or in the heel that occurs with walking, usually upon first steps and standing for a long period of time. This malady is a result of the weakening of the plantar fascia, a flat band of connective tissue that spans between the heel and big toe, due to repetitive stress of weight bearing activities such as walking and running. Adjusting footwear, decreasing body weight, practicing stabilizing exercises and stretching the calf, foot and ankle are important to consider when seeking to reduce pain and discomfort from this condition.
The Facts:
It is estimated that 2 million Americans suffer from Plantar Fasciitis and that 10% of the population will be affected over the course of their lives. Plantar Fasciitis generally affects men and women between the ages of 40 and 60, although it can occur in children and teens, especially athletes. Women, men and women who live a sedentary lifestyle and men and women who dramatically increase their physical activities on the weekends are most likely to develop Plantar Fasciitis.
Plantar Fasciitis is an inflammation and deterioration of the plantar fascia, a flat band of connective tissue that crosses the bottom of the foot supporting the arch, connecting the big toe to the heel. This protective and shock absorbing tissue becomes inflamed due to tight calf muscles, obesity, running or a sudden increase in high impact activities. When strained, the plantar fascia weakens, swells, and becomes irritated. As a result, pain in the heel or the bottom of the foot occurs when standing or walking.
The Symptoms:
Patients with Plantar Fasciitis describe the pain in their heel or bottom of the foot as “stabbing,” “searing” and/or “buring”. The pain is most acute when first getting out of bed in the morning or when standing up after being off of the feet for a long period of time. The pain, generally accompanied by stiffness, normally decrease after a few steps, although sometimes it does not entirely go away and can linger while you walk. Further, the pain can return after long periods of standing. The pain usually occurs in one foot, although it is possible for the pain to be in both feet.
If the pain occurs at night or is behind the heel then arthritis, heel bursitis or tarsal tunnel syndrome are other possible causes.
What is Happening:
The plantar fascia on the bottom of your foot, the thick band of connective tissue that spans from your heel to your big toe, acts as a protective and shock-absorbing shield for the feet and thus the entire body. With too much and/or repeated impact or pressure, the tissue tears, creating small micro tears in the tissue, straining this protective sheath and causing some degree of inflammation and swelling. The tears in the tissue cause the pain. These tears, small in magnitude, can heal in short spans of time, but if they keep tearing with continual impact and pressure, pain persists.
Why Is This Happening:
Although “itis” usually indicates an inflammation, studies of plantar fasciitis have shown that there is very little inflammation present. This explains why prescribed anti-inflammatories currently prescribed for the condition have little to no affect on the healing process. Instead, it has been found that the fascia is degraded due to repetitive wear and tear, and, as a result, becomes stressed and weakened.
Weak muscles in the foot and ankle and higher up in the knee and hip can cause too much pressure on the sole of the foot, thereby causing the tissue to weaken due to repetitive stress, causing plantar fasciitis. More specifically, excessive pronation or rolling inward of the feet, high arches or flat fleet and walking, standing or running for long periods of time, especially on hard surfaces and while wearing ill fitting or worn out shoes are causes of the condition.
Studies have shown that as much as 70% of people with plantar fasciitis are obese (almost twice as much as the 36% of the total population that is obese in America). Overweight individuals and pregnant women, both of whom have excessive weight on their feet when standing, are therefore susceptible to tightness in the Achilles tendon and calf muscle making them prime targets for plantar fasciitis.
Lifestyle Adjustments:
Small yet significant lifestyle changes can minimize the chances of developing Plantar Fasciitis.
1. Consciously maintaining a healthy weight to alleviate the chances of excess pressure on your feet while walking and standing. Remember, this excessive pressure places stress on the plantar fascia which ultimately leads to pain.
2. Wear properly fitted shoes with arch support and cushioned soles or padded heels to protect your feet from the wear and tear of walking on hard surfaces. Not only will your feet feel better but also your chance of developing Plantar Fasciitis along with various other foot related problems will diminish.
3. Spend time each night to massage your feet. Even something as simple as rolling a golf ball or frozen water bottle under your foot every night before you go to bed can keep the plantar fascia hydrated and pliable.
Prevent It
To minimizing the stress on the plantar fascia thereby preventing Plantar Fasciitis it is crucial to maintain a healthy weight, wear supportive shoes and stretch your feet, legs and hips daily. While it is important to stretch the calf muscles and Achilles tendons before and after activity (everything from a gym workout to walking or standing for long period of time) it is just as important to stretch those muscles along with the feet, legs and hips on the off days that you are not active or exercising. Keeping the feet, leg and hip muscles pliable potentially alleviates excessive pressure on the feet maintaining the health of the plantar fascia.
If you feel foot or heel pain, notice the patterns of when you feel the pain and the type of footwear you are wearing at that time. Choose more supportive shoes during those activities that cause pain and take time each day to stretch your feet, calf, leg and hip muscles as well as the Achilles tendon.
Fix It
The best way to fix and prevent plantar fasciitis is to find appropriate footwear. If you have an arch that is too big or too small it is critical that you get sneakers and/or insoles that are customized specifically for your foot. In addition, you can help improve your pain by stretching the calves and massaging the bottom of the foot, which will loosen up the tissues. Finally, you can strengthen the muscles in the foot to take pressure off of the fascia.
1) Take a water bottle and freeze it. Put it under your foot and roll it back and forth for 10 minutes. Repeat 3 times a day with at least 45 minutes in between applications
2) Calf stretch against the wall. 45 seconds 3 times a day
3) Marble pickups – 3 x 1 minute, twice a day