Plantar fasciitis

A very common inflammatory condition of the foot, plantar fasciitis causes pain at the base of the heel and may also result in problems with bending the foot.

Symptoms

Stabbing pain of the heel, often concurrent with your first steps of the day. Pain is frequently lessened as the foot has time to flex throughout the day. Similarly, the pain may return more violently after sitting down or extended periods of standing. You can also experience difficulty bending the foot upwards so that the toes move closer to the leg, known as decreased dorsiflexion. The condition usually affects only one foot, but can present in both.

Causes

The plantar fascia is a broad band of tissue that connects the heel bone to the toes, running along the bottom of the foot. Tears can form in the tissue when subjected to great tension. When this tearing and stretching is repeated the fascia becomes inflamed, causing the pain associated with plantar fasciitis. Damage to the plantar fascia commonly occurs in people who are required to spend a lot of time moving on their feet or standing on hard surfaces; in sport it is most typically found in runners.

The shape of your feet and the manner in which you walk can also instigate the condition, such as having flat feet or a high arch (instep) on the bottom of the foot, as this can mean that weight is not distributed correctly when you stand, putting increased stress on the plantar fascia. Inefficient shoes without suitable support for your feet also leave you at risk, with looseness, excessively thin soles and insufficient shock absorption all potential contributing factors.

Medical Exam

A doctor will make a diagnosis through a physical exam and imaging tests if necessary. They will inspect sites of tenderness in order to establish whether plantar fasciitis or another injury is causing the pain and inflammation. They may also test the strength and reflexes of your ankle.

Self-Treatment

Crucially, keep away from standing or running activities as much as possible until the pain becomes less intense. Change these high-impact activities for a pursuit such as cycling or swimming to maintain fitness without provoking further injury. If you feel you have to run, be conservative and cover shorter distances.

Ice the appropriate area for approximately 15 minutes, 3 times per day, or following any exercise. Massaging the area with a frozen cup full of water can also help to diminish the pain. Stretch and strengthen the significant muscles associated with your ankle and foot arches: the Achilles tendon, plantar fascia, and calf muscles. Stretching these muscles in bed can significantly reduce the pain felt with the first steps of the morning. Buy arch supports for your shoes from a specialist to mitigate the tension placed on the underside of the foot.

Prevention

Inadequate support from the shoes is a high risk factor, so you should always purchase shock absorbent shoes with decent arch support. Never run barefoot, and try to replace old shoes before they lose their support and absorption benefits. A guide for runners wearing athletic shoes is not to exceed 500 miles in the same pair.

Clinics & treatments

Sports medicine

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