Plantar fasciitis (also referred to as plantar heel pain syndrome, heel spur syndrome, or painful heel syndrome) is by definition, an inflammation of the plantar fascia. It is the most common cause of heel pain, accounting for 11-15% of all foot pain. The plantar fascia is a band that runs from the heel (calcaneus)of the foot and across the arch to the ball of the foot. This strong and tight tissue contributes to maintaining the arch of the foot and is one of the major transmitters of weight across the foot as you walk or run. Therefore, the stress placed on this tissue is tremendous. It is often the result of poor biomechanics, improper foot wear or other conditions such as Iliotibial Band Syndrome.
Symptoms of plantar fasciitis are typically worsened early in the morning after sleep. At that time, the arch tissue is tight and simple movements stretch the contracted tissue. This makes the first few steps out of bed very painful. Pain is usually felt at the heel of the foot or within the arch of the foot. As you begin to loosen the foot, the pain usually subsides, but often returns with prolonged standing or walking.
In most cases, plantar fasciitis develops without a specific, identifiable reason. There are, however, many factors that can make you more prone to the condition:
- Tighter calf muscles that make it difficult to flex your foot and bring your toes up toward your shin
- Very high arch or very low arch (increased pronation)
- Repetitive impact activity (running/sports)
- New or increased activity
Treatment and Prevention
You can decrease your risk of developing plantar fasciitis by:
- Wearing customized orthotics
- Ensuring supportive footwear
- Stretching (plantar fascia and Achilles tendon especially)
- Gradually increasing training intensity
Recommended treatments include:
Stretching of the plantar fascia and Achilles tendon are important in the treatment of plantar fasciitis. The goal of this stretching program is to relieve the stress put on the plantar fascia by either the plantar fascia itself being tight or the fascia beign tightened by a tight Achllies tendon, as both the plantar fascia and Achilles tendon insert onto the calcaneus (heel bone).
- Calf (Achilles tendon) stretch – Lean forward against a wall with one knee straight and the heel on the ground. Place the other leg in front, with the knee bent. To stretch the calf muscles and the heel cord, push your hips toward the wall in a controlled fashion. Hold the position for 20seconds and relax. Repeat this exercise 20 times for each foot. A strong pull in the calf should be felt during the stretch.
- Plantar fascia stretch – This stretch is performed in the seated position. Cross your affected foot over the knee of your other leg. Grasp the toes of your painful foot and slowly pull them toward you in a controlled fashion. If it is difficult to reach your foot, wrap a towel around your big toe to help pull your toes toward you. Place your other hand along the plantar fascia. The fascia should feel like a tight band along the bottom of your foot when stretched. Hold the stretch for 15-20 seconds. Repeat it 20 times for each foot. This exercise is best done in the morning before standing or walking.
Ice can also be helpful in managing this condition. Rolling your foot over a cold water bottle or ice for 20 minutes is effective. This can be done 3 to 4 times a day.
Night splints. Most people sleep with their feet pointed down. This relaxes the plantar fascia and is one of the reasons for morning heel pain. A night splint stretches the plantar fascia while you sleep. Although it can be difficult to sleep with, a night splint is very effective and does not have to be used once the pain is gone.
Plantar fasciitis can easily become a chronic condition, if you are not experiencing any results from the above, please contact your health care provider. As a chiropractor I have access to numerous modalities, including laser therapy, Active Release Technique and physical therapy, that are effective in treating plantar fasciitis.
For more information or to book a complimentary consult please contact our office at 905-820-7746 or send me an email at firstname.lastname@example.org