Author: Chloe Wilson - BSc(Hons) Physiotherapy
Plantar fasciitis symptoms of pain and tenderness under the heel are a common problem. Plantar fasciitis is a common cause of heel pain and affects approximately 1-in-10 people. It develops when there is damage and inflammation of the plantar fascia, the thick band of tissue on the sole of your foot. Plantar fasciitis usually develops due to overuse.
But exactly what is plantar
fasciitis? Here we will look at the causes, symptoms and treatment options as
well as how to prevent this common cause of foot pain.
The plantar fascia is a thick, tough, fibrous band made up of collagen fibres, which runs along the sole of your foot. It originates from the heel bone (calcaneus), extends along the bottom of the foot and attaches to the bottom of the toes. It helps to support the arch of your foot and transfers forces across your foot when you walk or run.
There are three parts to the plantar fascia. The central portion is the largest with smaller bands coming out of each side known as the medial and lateral portions.
Plantar fasciitis symptoms develop if too much strain is placed on the plantar fascia, usually from overuse or repetitive actions, causing small tears to develop in the collagen fibres. This results in swelling and inflammation. If the problem continues, it may develop into plantar fasciosis, which means there is chronic degeneration of the tendon rather than inflammation.
In approximately two-thirds of cases, plantar fasciitis symptoms are accompanied by the presence of a bone spur. When there is repeated tension on the plantar fascia, it pulls on the area of bone where the tendon attaches to the heel bone, known as the calcaneal tubercle.
The body responds by laying done excess bone, known as a heel bone spur, to try and protect itself from injury. People often mistakenly think it is the bone spur that causes the plantar fasciitis, but in actual fact, the bone spur develops as a result of the condition.
Plantar fasciitis symptoms often develop for the following reasons:
1) Overuse: Being on your feet for long periods, be it standing, walking or running, especially on hard surfaces
2) Altered Foot Biomechanics: Abnormal foot positions such as flat or high foot arches or excessive pronation increase the strain on the plantar fascia
3) Weight: Being overweight places more strain through the tendon
4) Muscle Tightness: The plantar fascia is closely linked with the Achilles tendon and calf muscles. Tightness and weakness in the calf therefore predispose the plantar fascia to injury by causing it to repeatedly overstretch.
5) Poor Foot Wear: Wearing shoes that are worn, lack good arch support and cushioning
6) Exercise: Suddenly increasing the amount you exercise (frequency or intensity), or changing the surface you exercise on e.g. from track to road
7) Age: It most commonly affects people between the ages of forty and sixty
8) Gender: Women are twice as likely to suffer from it as men
The most common of plantar fasciitis symptoms is pain that is worse after rest, either first thing in the morning or after sitting for long periods. This is because the fascia tightens slightly. As you walk around, it then stretches out slightly and symptoms often improve. However, if you are on your feet too much, the plantar fasciitis symptoms return.
Pain is usually felt underneath the heel where the tendon arises from the heel bone, approximately four centimetres forwards from the back of the heel. It is usually tender to touch.
Plantar fasciitis symptoms are often worse when the foot and toes are pulled up (known as dorsiflexion) as this increases the tension on the tendon. Other activities where the plantar fascia is stretched e.g. standing on your tip toes or walking up stairs also tend to increase the pain.
Your doctor can usually diagnose the condition from talking to you about your pain and examining your foot. Occasionally, he may carry out other tests such as x-rays or ultrasound scan to rule out other causes of pain.
Plantar fasciitis symptoms usually resolve but they can take months. Studies have shown that the sooner plantar fasciitis treatment is started after symptoms develop, the quicker the recovery process.
In the plantar fasciitis treatment section we look at the top 10 treatments for treat plantar fasciitis including exercises, which orthotics work best, injections and surgery.
In order to prevent the onset or recurrence of plantar fasciitis symptoms, there are a number of things you can do:
1) Wear Good Footwear: Flat shoes that provide good cushioning and arch support. You may also benefit from orthotic inserts in your shoes
2) Stretching Exercises: regularly stretching the calf muscles and plantar fascia is one of the best ways to reduce the chance of developing the condition
3) Strengthening Exercises: Strengthening the foot, ankle and calf muscles reduce the chance of developing plantar fasciitis
4) Lose Weight: But only if you are overweight. Always talk to your doctor before starting any weight loss programmes
5) Exercise Appropriately: Avoid over training, particularly if you are just starting out and try and avoid hard surfaces
6) Toe Stretchers: Products like the Yoga Toe or Happy Feet Toe Stretcher Socks help to stretch out the muscles and ligaments around the feet. This in turn helps to realign the bones. People often find they are a great way to reduce the pain of plantar fasciitis.
You can find out more about how they work and read user reviews in the Toe Stretchers section.
You can find out more about the best ways to treat and prevent plantar fasciitis in the plantar fasciitis treatment section including the most effective exercises, which shoe insoles work best, injections and when surgery is indicated.
If these plantar fasciitis symptoms aren't sounding quite like your problem, visit the foot pain diagnosis for help working out what is wrong.
Page Last Updated: 14/01/19
Next Review Due: 14/01/21