Plantar Fasciitis: What It Is, Why It Happens, and How to Fix It

Have you ever felt a stabbing pain in your heel, especially when you take your first steps in the morning? If so, you might be dealing with plantar fasciitis, a common foot condition that affects people of all activity levels.

Let’s dive into what plantar fasciitis is, why it happens, and how you can find relief.

What Is Plantar Fasciitis?

Plantar fasciitis is a fancy term for irritation and damage to the plantar fascia, a thick band of tissue running along the bottom of your foot. This tissue supports your arch and helps absorb shock when you walk or run. When it gets overworked, tiny tears can develop, leading to pain and stiffness in your heel.

Who Is Most at Risk?

Plantar fasciitis doesn’t discriminate, but certain groups are more prone to it. Here’s who’s most at risk:

• Middle-aged adults: Most cases occur between 40 and 60 years old.
• Runners and athletes: Up to 17.4% of runners experience this issue due to repetitive stress.
• Those with higher body weight: Carrying extra weight increases strain on your feet.
• People with limited ankle and toe mobility: Reduced mobility of the joints around the foot and ankle, may cause altered loading of the plantar fascia.

How Does It Feel?

The most common symptom is sharp pain in the heel, particularly:

• First thing in the morning or after sitting for a while.
• During or after weight-bearing activities like walking, running, or standing.

Over time, this pain can become chronic, lasting months or even years without proper treatment.

The Science Behind Plantar Fasciitis

Did you know that plantar fasciitis isn’t just about inflammation? While inflammation may occur early on, the condition may also involve degeneration of the tissue, similar to how a frayed rope starts to break down. That’s why health professionals now often refer to it as “plantar fasciopathy”.  ('-itis' implies inflammation, whereas '-pathy' is more general - it means pathology, with is a condition or disease).

How Is It Diagnosed?

Most cases are diagnosed through a physical exam.  In rare cases, imaging tests like ultrasound or X-rays might be used. Ultrasound can reveal thickened plantar fascia tissue, often a telltale sign.

Treatment: From Simple Fixes to Advanced Solutions

Thankfully, plantar fasciitis is treatable, and most people can manage it without surgery. Here’s how:

1. Home Remedies Guided by Physical Therapists

• Stretching: Simple stretches for the plantar fascia and calf muscles can work wonders. Stretching programs are often effective in improving pain within the first two weeks to four months.
• Strengthening: Strengthening the muscles of the calf and foot, can help off-load the stress placed upon the plantar fascia when weight-bearing
• Supportive Shoes and Insoles: Custom or over-the-counter insoles can reduce strain on your arch.

2. Professional Treatments

• Shockwave Therapy: This non-invasive treatment uses sound waves to encourage healing and has shown excellent results for pain relief.
• Platelet-Rich Plasma (PRP) Injections: PRP involves injecting a patient’s own blood-derived plasma to boost tissue repair. Studies suggest it’s effective, especially in the long term.
• Corticosteroid Injections: These can provide short-term relief but should be used cautiously as they can weaken the plantar fascia over time.

3. Surgical Options

Surgery is typically a last resort for chronic cases. One approach, endoscopic plantar fasciotomy, can improve outcomes but comes with risks.

What About Prevention?

Whether you’ve had plantar fasciitis or want to avoid it, prevention is key. Here’s how you can protect your feet:

• Keep your weight in a healthy range to reduce foot strain.
• Invest in supportive footwear, especially if you’re on your feet often.
• Incorporate foot and calf stretches and strengthening into your routine to keep those tissues flexible and strong.
• Increase your activity gradually.  For instance, increasing your running time or running distance by no more than 10% a week can reduce the risk of injuries including plantar fasciitis.  

The Takeaway

Plantar fasciitis is painful, but it doesn’t have to rule your life. With a combination of home care, physical therapy, and advanced treatments when needed, you can get back on your feet—literally!

Written by Tiago Oliveira in collaboration with River East Physiotherapy

If you’re struggling with heel pain, don’t wait. Our physiotherapists can help you craft a plan to feel better fast.

Not sure if physiotherapy is right for you?  Call us for a FREE 15-minute phone consultation with a physiotherapist.

References:
Rhim, H. C., Kwon, J., Park, J., Borg-Stein, J., & Tenforde, A. S. (2021). A Systematic Review of Systematic Reviews on the Epidemiology, Evaluation, and Treatment of Plantar Fasciitis. Life, 11(12), 1287. https://doi.org/10.3390/life11121287