Plantar Fasciitis
(Heel Pain)

A very painful but treatable condition

When Every Step Hurts

Plantar Fasciitis is the most common cause of heel pain. Your plantar fascia is a thick band of tissue that supports the arch of your foot and connects your heel bone to your toes. If you strain this tissue it can become swollen and inflamed, thus causing pain in your heel and throughout your entire arch when you stand or walk.

What is it?

Plantar fasciitis can be an extremely painful condition in the foot. This is because each and every step puts stress on the plantar fascial tissue. As you walk or even stand the plantar fascia can become inflamed, which contributes to increased discomfort and pain that only worsens over time. The pain associated with plantar fasciitis usually begins in the heel and as the condition becomes severe it can spread through the entire arch of the foot. Plantar Fasciitis should be treated as early in the onset as possible because the longer it persists without proper treatment the longer it can take to heal.

Plantar fasciitis pain is usually the sharpest when you take your first steps in the morning and can make it difficult to step out of bed. This is because throughout a night of rest the plantar fascia contracts and micro-healing occurs. The abrupt stretching of the tissue during those first morning steps causes immediate pain and increased inflammation of the plantar fascia. The pain usually decreases after some movement, but often returns after long periods of standing or when you rise from a long period of sitting. Also, pain associated with plantar fasciitis usually increases after exercise, not during it.

What Causes it?

Strain and inflammation of the plantar fascia is the primary cause of the heel and arch pain felt with plantar fasciitis. Those who overpronate and roll their feet inward as they walk are more susceptible to developing the condition, but it can show up in all foot types including high arches and flat feet.

Often plantar fasciitis is caused by wearing shoes that do not have proper support. Soft, cushy shoes that bend easily generally aggravate the condition, as well as do flat shoes with no support. Other contributing factors can include being overweight, frequent running, and occupations that keep you on your feet while on hard surfaces for long periods of time. Many cases of this painful condition have been found in those who stand or work on cement surfaces all day long.

What Can I do?

Basic home treatment is often effective for plantar fasciitis, the most important factor being supportive shoes. Arch supports and orthotics can also be very helpful in relieving the pain for this condition, particularly supports with deep heel cups which funnel the fat pad of the heel beneath the heel bone, causing it to act as a natural cushion. Often people do not realize the difference the supportive shoes and inserts can make in the healing process and turn to more expensive medical options first. But many who focus on supportive footwear along with light stretching and ice experience complete relief from the symptoms over time.

If you are suffering from plantar fasciitis it is important to rest your feet and avoid activities that make your feet hurt. This will allow time for the plantar fascia to heal. Ice the painful area for 15 to 20 minutes a few times a day, especially after activity. Over the counter pain medication may be needed to reduce swelling in the heel and ankle when the condition is flared up. Gentle toe, calf, and arch stretches can be helpful, especially first thing in the morning before stepping your foot onto the floor. Lightly massaging the foot with a tennis ball a few times throughout the day can also help provide relief. If you need to exercise you may want to try low-impact sports, such as swimming or riding a bike, instead of walking or jogging. As the condition improves you can slowly work back into exercise and sports that have higher impact.

Once you develop plantar fasciitis you will want to avoid walking in your bare feet, especially on hard surfaces such as wood floors or cement. This tends to aggravate the condition. A supportive slipper or house shoe can be worn in the house and should be placed on the foot first thing in the morning before the foot comes into contact with the floor. The immediate relief will be felt and the supporting the arch of the foot first thing in the morning will allow the micro-healing that took place throughout the night to remain intact. Once your plantar fasciitis is gone, it is generally best to remain in the habit of never walking around barefoot. Those who have developed plantar fasciitis once in their life are very susceptible to developing it again. It is wise to continue selecting supportive footwear and protecting the foot from conditions in which the plantar fasciitis could redevelop.

If your plantar fasciitis pain is persistent after basic home treatment you should make sure to see a doctor. There are more extensive procedures that can be helpful in relieving the pain, which can include cortisone shots and other procedures. Surgery is rarely need for this condition and is usually only considered when all else fails as it is not a desirable option.

A physical therapist may recommend certain exercises to strengthen your lower leg muscles and stretch the plantar fascia and Achilles tendon, thus stabilizing your ankle and heal. These can be very beneficial in helping to improve the condition. Your doctor may also recommend night splints to help with stretching your calf and the arch of your foot while you sleep.

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