Plantar fasciitis is a common cause of heel pain. The term "plantar" refers to the sole of the foot, and the fascia is a flat band of connective tissue that encloses muscles and separates layers of tissue. The plantar fascia is attached at the center of the heel bone, and stretches across the bottom of the foot, connecting the heel bone to the toes and supporting the arch. Chronic heel pain is sometimes called plantar fasciosis.
History
Plantar fasciitis used to be called "heel spur syndrome" because of the bone spurs that can form. Bone spurs are merely a result of the problem, however, not the cause of the heel pain. The pain of plantar fasciitis is caused by the tearing of the fascia where it connects into the heel bone.
Identification
The main symptom of plantar fasciitis is a stabbing pain in the heel that is usually worse in the morning, or during the first few steps you take after standing up. There also may be some swelling and pain when you push off with your toes while taking a step. It usually develops gradually, and can be only in one foot, or worse in one foot than in the other. A physician can diagnose plantar fasciitis, and may order an X-ray or MRI to rule out other possible causes of heel pain such as sciatica, tarsal tunnel syndrome, Achilles tendonitis or plantar fascia rupture.
Causes
The plantar fascia normally supports the arch of the foot like a bow-string and acts as a shock absorber during walking and running. The rolling motion of the foot slightly inward during a step is called pronation. Some people overpronate, or roll inwards too much, during walking or running. During this excessive pronation, or "overpronation," the arch of the foot flattens out, causing the fascia to stretch too far and the foot to become unstable. Plantar fasciitis is also more common in men over 40, possibly because their plantar fascia is less elastic, and pregnant women.
Other factors can contribute to plantar fasciitis. Part of your risk for developing plantar fasciitis is genetic, related to how your foot and ankles are formed. Being overweight can cause excessive stress on the plantar fascia, as can wearing shoes that bend in front of the toe joint or are too flexible in the arch. Drastically increasing the duration of your runs can contribute to plantar fasciitis as well.
Treatments
If you develop heel pain after an increase in the length, intensity or frequency of running, cut back the activity. Once recovered, gradually build up the intensity of your workouts, and buy running shoes that provide more stability and correct overpronation.
Gentle daily calf stretches can help, too. Lean your hands against the wall and keep one leg slightly bent in front of you, and the other leg behind you and straight, Hold the stretch for 10 seconds, then switch legs. Never bounce while stretching. Perform 10 repetitions twice a day. Also try "toe curls" for 20 seconds twice a day to strengthen foot muscles (see Resources).
Devices such as inclines or half-moon-shaped wheels can assist with a foot stretch, but be sure to follow the instructions, and stop if it hurts. There are also plantar fasciitis socks that use a strap to gently pull the toes back to stretch the foot as you sleep at night.
Other things you can do at home to help alleviate plantar fasciitis is to ice the foot twice a day for 15 minutes each time. You also can buy over-the-counter orthotics to provide more arch support and stability, and avoid walking barefoot, even around the house, for six weeks after a flare-up of plantar fasciitis. If home treatments are not effective, see a podiatrist. A podiatrist can evaluate your gait, and take standing X-rays of your feet and prescribe a physical therapy regime.
Prevention/Solution
A good way to prevent plantar fasciitis and other sports-related injuries is to increase the duration and intensity of your workouts gradually and carefully. Wear a good shoe with plenty of arch support and shock absorption. If you run regularly or long distances, it is important to wear a shoe that is designed for that purpose.
Runners often develop excessive tightness in calves and hamstrings, so they must stretch regularly to prevent any imbalance. Cross-training with a variety of activities also can help prevent the repetitive-motion injuries that can trigger plantar fasciitis.
Most important, listen to your body. Pay close attention to which activities lead to heel pain. Keep a workout journal to track any possible cause and effect of foot pain.
Tags: heel pain, plantar fascia, plantar fasciitis, heel bone, plantar fasciitis, arch foot