Definition

Plantar fasciitis is inflammation of the plantar fascia, a thick connective tissue that runs from the heel (calcaneus) to the toes (metatarsals). This tissue helps support the arch of your foot. It is a nagging injury that can often take months to resolve completely.

Symptoms

A dull ache or bruise pain at the medial heel and into the arch of the foot. Pain is usually most pronounced in the morning upon taking your first steps out of bed. This can occur in one or both feet at the same time.

Potential Causes

Plantar fasciitis is associated with long durations of weight bearing, poor footwear selection, and increasing walking and/or running distances too quickly. Tightness in the calf muscles (gastroc and soleus muscles) and great toe ("big toe") flexors predispose runners to this condition. It is common that people who suffer from plantar fasciitis have abnormally high arches or flat feet with this condition.

Preventative Techniques/Treatments

Several steps can be taken to prevent plantar fasciitis or treat it if you have been diagnosed with this painful condition. Selecting specific shoes that fit your feet and ankles and any gait abnormalities is crucial in preventing all running injuries. You want your shoes to put your foot and ankle in a "anatomically neutral" position. It is important to obtain your running shoes from a shoe store with trained staff that will analyze your gait and make specific recommendations on proper footwear. If you have severe arch problems or a foot that over-pronates or over-supinates you may benefit from off-the-shelf or custom orthotics. We will get more specific with orthotic recommendations. Effective stretching of the calf helps reduce abnormal stress on the plantar fascia. Gradually increasing your mileage is vital to avoiding plantar fasciitis, along with all overuse related running injuries.

If you have been diagnosed with plantar fasciitis it is best to perform active rest by introducing some cross training into your routine. Temporarily reduce your running mileage, adding some swimming or biking into your training. Spend more time stretching the calf and great toe flexors (see photos). Ice the bottom of your foot with the ice massage effect of a frozen water bottle (see photo). Avoid walking barefoot, especially in the mornings. Try slipping into a shoe or slipper that has somewhat of an arch support in the mornings. The use of a stretching sock, Strassburg sock, will stretch your calf and toes during the night. If the pain persists, I would recommend seeing an doctor and trying physical therapy. Physical therapy is very successful in treating plantar fasciitis with the use of specific exercises, aggressive stretching, therapeutic ultrasound, manual massage, and kinesiotaping. Your physical therapist can also provide a gait analysis to help indentify gait abnormalities.

Below are pictures of (a.) the most common location of pain, (b.) a kinesiotaped foot, and (c.) effective plantar fasciitis avoidance and treatment stretches: