Plantar fasciitis is inflammation, usually due to injury, of the plantar fascia, the ligament between the front of the heel bone and the base of the toes that helps to support the arch.
It causes severe pain on the bottoms of the feet, especially in the morning.
Excess stress absorbed by the foot may irritate or tear the plantar fascia, making this a common disorder among athletes, especially runners.
Plantar fasciitis can be caused by a tendency of the foot to roll inward (pronation) upon walking.
Other factors may be stress on the heel due to repeated hard pounding or quick turns, often from long-distance running, jogging, or basketball; wearing shoes that lack proper heel support or that have thin or stiff soles; age-related loss of resiliency in the ligaments; and some forms of arthritis, such as ankylosing spondylitis or Reiter's syndrome.
Plantar fasciitis occurs only on the sole and heel of the foot. It can cause pain along the entire length of the plantar fasciae and where these ligaments attach to the heel bone in the rear foot and the five metatarsal bones.
Patients often report severe pain on the bottoms of their feet in the morning, especially the first steps out of bed. The pain subsides after a few minutes of walking.
The diagnosis is made by medical history and physical exam.
In severe cases, a corticosteroid injection into the tender area may provide relief. Rarely, surgery to release the plantar fascia from its attachment may be necessary.
What is the probable cause?
Could another medical condition have caused it?
How should this be treated?
Can you suggest exercises that can be done?
What can be done to prevent further injury?
Under what circumstances would surgery be necessary?
- Rest the foot as much as possible, especially during the first week. Avoid jogging, running, and excess standing; instead, substitute exercises that do not put undue stress on the injured ligament, like bicycling or swimming.
- Apply ice to the tender area a few times daily to reduce inflammation. Try rolling the arch of the foot over an empty tennis ball can that has been filled with water and frozen; this both cools and stretches the affected area.
- Take over-the-counter pain relievers (ibuprofen, naproxen) to reduce pain and inflammation.
- Insert an over-the-counter arch support and heel support cushion into the shoe. Cut a hole in the pad to relieve pressure on the tender area if necessary. Try to avoid walking barefoot, since it may put added stress on the plantar ligament.
- Sit on a table with your knees bent. Loop a towel under the ball of the injured foot and pull, flexing the front of your foot upward. Keep your knee bent and try to press your foot against the towel.
- Sit on a chair and cross the ankle of the injured foot over the opposite knee. Slowly push the toes backward with your hand until you feel the stretch in the bottom of your foot.
- Stand facing a wall, about one foot away, with the injured foot about six inches farther back. Put your hands on the wall and gently lean forward, stretching the lower calf.
- Stand facing a wall, about two feet away, with the injured foot about six inches farther back. Keep both feet slightly turned outward. Put your hands on the wall and gently lean forward, bending the front knee and keeping the back heel on the floor.