Plantar fasciitis [fashee-EYE-tiss] is a persistent, painful condition at the bottom of the foot, particularly in the heel and arch of the foot. Approximately one in 10 people in the United States experience this prolonged foot pain at some point in their lives. Recovery time is faster in those who receive evidence-based physical therapy for their foot pain.
The plantar fascia is a ligament directly underneath the skin on the bottom of your foot. This ligament covers the muscles in the sole of the foot, extending along the bottom of the foot and connecting each of the toes to the heel bone.
The plantar fascia strengthens and supports the arch of the foot for walking and running, and also serves as a shock absorber during the daily wear and tear of routine walking and running movements.
When there is too much pressure on the feet, this can irritate, strain, or tear the plantar fascia ligaments as the collagen in the ligaments becomes disorganized and subsequently degenerates. The body’s natural response to such injury often results in stiffness in the foot, as well as heel pain and pain in the arch of the foot, and this pain is termed plantar fasciitis.
Who is at Risk?
Plantar fasciitis is often experienced by those who spend a great deal of time on their feet on hard surfaces, particularly after age 40. In pregnant women, the additional weight of pregnancy can lead to plantar fasciitis, most often during late pregnancy. Others who are at risk for plantar fasciitis include:
- Nurses and nurse technicians
- Factory workers
- Restaurant servers
- Athletes who perform repetitive activity, such as running and/or jumping
- Those who work on concrete floors
Common contributing factors for plantar fasciitis are:
- New activity or a sudden increase in activity
- Obesity, which places extra weight on the feet and plantar fascia
- Tight calf muscles
- Flat feet
- High-arched feet
- Wearing thin, flat shoes without adequate arch supports
Small, repeated injuries over time may damage the plantar fascia. In some instances, a triggering event or a clear cause of plantar fasciitis cannot be determined.
Symptoms of Plantar Fasciitis
Symptoms typically develop gradually in one foot, although both feet can be affected. The most common complaints in plantar fasciitis are heel pain and/or pain at the bottom of the mid-foot area, and pain that worsens with the first few steps after getting out of bed in the morning or after a period of prolonged activity. Some people describe the pain as a burning sensation or an ache on the bottom of the foot, running outward from the heel, while others report the pain as a dull, sharp, or stabbing pain.
Making the Diagnosis
A health care practitioner obtains a medical history and performs a physical examination in order to diagnose plantar fasciitis. The examiner may apply gentle, brief pressure on the bottom of the foot in order to confirm that the pain is originating from the plantar fascia. Although imaging studies and other tests are not needed to diagnose plantar fasciitis, they may be used to determine any other possible causes of foot pain, such as a nerve injury or a broken bone.
Treatments for Plantar Fasciitis
When a clear trigger can be identified – such as a recent increase in high-impact exercise – then decreasing the amount of activity or eliminating the activity for a period of time will lessen the pain.
Current research has found that patients who were sent to physical therapy for their foot pain experienced faster recovery when receiving evidence-based physical therapy.
Treatment options from your physical therapist at Physical Therapy Now include calf stretches, foot stretches, application of ice, foot taping, use of a night splint, and hands-on therapy. With these conservative treatments, research shows that most cases of plantar fasciitis resolve over time, and surgery is rarely required.
Our highly skilled physical therapists at Physical Therapy Now are ready to help! Call us today at (305) 570-1666 for help in resolving your foot pain as soon as possible.