The plantar fascia is a tough and flexible band of tissue that runs under the sole of the foot. It connects the heel bone with the bones of the foot, and acts as a kind of shock absorber to the foot.
Sudden damage, or damage that occurs over many months or years, can cause tiny tears (microtears) to develop inside the tissue of the plantar fascia. This can cause the plantar fascia to thicken,
resulting in heel pain. The surrounding tissue and the heel bone can also sometimes become inflamed.
The plantar fascia is designed to absorb the high stresses and strains we place on our feet. But, sometimes, too much pressure damages or tears the tissues. The body's natural response to injury is
inflammation, which results in the heel pain and stiffness of plantar fasciitis.
Most patients with plantar fasciitis describe a sharp or stabbing pain on the bottom of the heel that is most severe when they first get up in the morning or after a period of resting. Some may feel
like the heel is bruised while others may describe tightness or even a pulling sensation on the heel or arch.
X-rays are a commonly used diagnostic imaging technique to rule out the possibility of a bone spur as a cause of your heel pain. A bone spur, if it is present in this location, is probably not the
cause of your pain, but it is evidence that your plantar fascia has been exerting excessive force on your heel bone. X-ray images can also help determine if you have arthritis or whether other, more
rare problems, stress fractures, bone tumors-are contributing to your heel pain.
Non Surgical Treatment
The key for the proper treatment of plantar fasciitis is determining what is causing the excessive stretching of the plantar fascia. When the cause is over-pronation (flat feet), an orthotic with
rearfoot posting and longitudinal arch support is an effective device to reduce the over-pronation and allow the condition to heal. If you have usually high arches, which can also lead to plantar
fasciitis, cushion the heel, absorb shock and wear proper footwear that will accommodate and comfort the foot. Other common treatments include stretching exercises, plantar fasciitis night splints,
wearing shoes that have a cushioned heel to absorb shock, and elevating the heel with the use of a heel cradle or heel cup. Heel cradles and heel cups provide extra comfort, cushion the heel, and
reduce the amount of shock and shear forces placed during everyday activities.
Surgery is rarely needed in the treatment of plantar fasciitis. The vast majority of patients diagnosed with plantar fasciitis will recover given ample time. With some basic treatment steps, well
over 90% of patients will achieve full recovery from symptoms of plantar fasciitis within one year of the onset of treatment. Simple treatments include anti-inflammatory medication, shoe inserts, and
stretching exercises. In patients where a good effort with these treatments fails to provide adequate relief, some more aggressive treatments may be attempted. These include cortisone injections or
extracorporeal shock wave treatments.
Making sure your ankle, Achilles tendon, and calf muscles are flexible can help prevent plantar fasciitis. Stretch your plantar fascia in the morning before you get out of bed. Doing activities in
moderation can also help.