Foot Pain: Plantar Fasciitis

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It’s likely that at some point in our life we have all experienced some discomfort on the bottom of our foot. It typically comes and goes, but what is going on when it hangs around for more than a few weeks?

What is Plantar Fasciitis?

Plantar fasciitis is considered an overuse syndrome of the bottom of the foot. The plantar fascia is a thick band of connective tissue on the bottom of your foot that can become irritated with overuse.

Who gets it?

Approximately 1 in 10 people get plantar fasciitis, and it is most commonly reported in women 45-64 years of age. Limited dorsiflexion range of motion (how high you can lift your foot up) is also associated with plantar fasciitis. People who have jobs or hobbies that require prolonged standing tend to have higher reports of heel pain.

What are the most common symptoms?

Heel pain, especially when you first wake in the morning or get up from sitting/laying after a long time. You may also notice heel pain with prolonged walking/running or standing.

Why do we get it?

Why we get plantar fasciitis is not completely understood. The word ending “itis” in the medical world means inflammation, so plantar fascia + itis = inflammation of the planar fascia. In recent years this has proved to be somewhat of a misnomer, as detailed research into the painful plantar fascia indicates the problem is poorly related to inflammation, but more to weakening and shortening of the connective tissue. This is described in the term “fasciosis” (“osis” meaning abnormal tissue). 

How long does it take to get better?

Good news! Plantar fasciitis/fasciosis is often a self-limiting condition that resolves without the need for intensive medical intervention, but it can take sometimes take up to 10 months.

What can I do about it?

While it will often improve on it’s own, there are definitely things YOU can do to help decrease your pain and improve your function if you are dealing with plantar fasciitis.

  • Wear supportive and appropriate shoes (try to avoid high heels, unsupportive sandals).
  • Modify your activity as you are able. For example, you might have notice persistent pain on the bottom of your foot or heel since you started walking more. Try decreasing the distance walked and substituting with other activities that require less time on your feet like cycling or swimming.
  • Roll your arches on a tennis ball, lacrosse ball, frozen water bottle, or other object for 1-2 minutes before getting up.
  • Stretch your calf muscles. A great way to do this is to stand with both hands on a wall, one leg back with the knee straight, and one leg forward with the knee bent. Keeping your back heel on the floor, lean forward toward the wall. Hold for 30 seconds, 3 times. Repeat on both sides.
  • Stretch your plantar fascia. Do this by either crossing your foot over your knee or bending forward toward your foot on the floor. Pull your big toe backward gently so you feel a stretch on the bottom of the foot. Hold for 1 min, 3 times.
  • Strengthen your calf muscles. We talked about how the plantar fascia gets week, so strengthening is a huge key to improvement! The tough part about this…it causes discomfort while you are doing it. Start small by standing on both feet, then lifting up onto your tip toes for 3 sets of 5 repetitions. Know that some discomfort while you are doing the activity is okay, it should go away within a few minutes of finishing the exercise. (Remember, you may have muscle soreness 24-48hrs afterward in your calf or foot – this is normal and should feel different than your normal foot pain). Perform on both sides, and add repetitions when you can tolerate 3 sets of 5!

When to see a Physical Therapist:

  • If your pain is consistently debilitating or causing significant difficulty with your daily activities or job.
  • If you try managing on your own but don’t feel successful or have further questions.
  • If you have other conditions that make exercise more challenging or make you feel unsafe.
  • If, in addition to heel pain, you have numbness or tingling in your foot or leg.

If you feel like any of the above statements apply to you, call us at 254-892-4857 to set up an appointment with Dr. Maggie Roeger, our orthopedic specialist!

References:

1. Current Concepts of Orthopedic Physical Therapy, 3rd Edition. The Foot & Ankle: Physical Therapy Management Utilizing Current Evidence. Jeff Houk, PT PhD. Christopher Neville, PT, PhD. Ruth Chimenti, PT, DPT

2. Lim, Ang Tee et al. “Management of plantar fasciitis in the outpatient setting.” Singapore medical journal vol. 57,4 (2016): 168-70; quiz 171. doi:10.11622/smedj.2016069

3. Nahin, R. Prevalence and pharmaceutical treatment of plantar fasciitis in United States adults. J Pain. 2018 August: 19(8) 885-896.

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