Reviewed by:
Dr. Jason O’Dell
McLeod Orthopaedics Florence

The plantar fascia is a long, thin ligament that lies directly beneath the skin on the bottom of your foot. It connects the heel to the front of your foot and supports the arch of your foot. If it tears or becomes inflamed, it can be painful to walk. That condition, called plantar fasciitis (fashee-EYE-tiss), is the most common cause of pain on the bottom of the heel. Approximately 2 million patients are treated for this condition every year. Adults over the age of 40 are more likely to get plantar fasciitis, but it can affect people of all ages.

The most common symptoms of plantar fasciitis include pain on the bottom of the foot near the heel. Sufferers frequently experience this pain with the first few steps after getting out of bed in the morning, or after a long period of rest, such as after a long car ride. The pain usually subsides after a few minutes of walking. However, greater pain can occur after (not during) exercise or more intense activity.

Risk Factors
In most cases, plantar fasciitis develops without a specific, identifiable reason. There are, however, many factors that can make you more prone to the condition:

• Tight calf muscles that make it difficult to flex your foot and bring your toes up toward your shin
• Obesity
• Women who are pregnant and are carrying extra weight, especially in the third trimester
• Foot structure, such as a very high arch or flat feet
• Repetitive impact activity (running/sports)
• New or increased physical activity
• If you have an active job where you are often on your feet

Treatment Options
Gentle, consistent stretching is the most effective non-invasive treatment for plantar fasciitis. It’s important to take a break from intense physical exercise so that your foot inflammation can calm down. Most foot specialists recommend icing the plantar fascia, performing your stretches on a regular basis (even after healing), and taking an anti-inflammatory such as ibuprofen if you need it. You should also be sure to wear sturdy shoes with adequate support and proper fit to help relieve heel pain and to prevent further damage. Orthotics and extra cushioned shoes may also be beneficial.

In cases that don’t respond to these conservative treatment methods, advanced techniques may be necessary. Physical therapy is an extremely beneficial non-surgical treatment for plantar fasciitis, along with cortisone injections. However, if the patient’s pain is severe and has been ongoing for more than 6 to 12 months, surgery to improve flexibility and help heal the chronic tissue deterioration may be helpful.

To learn more about plantar fasciitis, see an orthopedic specialist.