Plantar Fasciitis: What Causes it & Prevention Tips
What is plantar fasciitis?
A common cause of heel pain, plantar fasciitis is a result of chronic overload on the foot. Specifically, the plantar fascia is a band of tissue that runs from about the middle of the sole of the foot to the heel and acts as a natural shock absorber.
When this tissue is damaged, you feel pain in the bottom of your foot, near the heel bone. The pain is usually the worst when you step out of bed in the morning, then gets better with continued walking. Pain usually gets worse AFTER exercise, not during. Often, there is a tightness in the calf too, which makes it uncomfortable or difficult to flex the toes up, but makes the pain go away when they are pointed down.
Can plantar fasciitis be prevented?
Some people are more likely to get plantar fasciitis than others. Some risk factors include:
- Being a runner
- Standing for long periods of time, especially on a hard floor
- Not staying active with exercise, then starting a new activity
- Having flat feet or high arches
- Having tight, shortened, or weakened tendons and muscles in your feet and ankles – see stretching tips in the next section.
Some of those things are easy to change, and some are impossible. One important factor in plantar fasciitis prevention is footwear. Some footwear tips for those most prone to plantar fasciitis:
- Avoid running barefoot
- Use adequate heel cushioning – adding a shock absorber to your shoe means your foot doesn’t have to work as hard to do the job
- Choose good arch supports – sometimes insoles may be needed to increase arch height
- Pick supportive shoes designed for plantar fasciitis – ideally, shoes with supportive sides and back support
- Quality counts – poor footwear increases the risk of heel pain
Can plantar fasciitis be healed?
For most people, plantar fasciitis relief can be found in simple measures:
Rest From Strenous Activity
Decreasing the activity that caused the pain may be possible and helpful, like if the pain started right after you picked up step aerobics.
Ice The Pain Points
Rolling the foot on ice or a cold water-bottle can be soothing.
Consult with Doctor About Pain medication
Ask your doctor about taking any pain medication for longer than a month.
Do Foot Stretches
To relieve the tight muscles that contribute to plantar fasciitis, try calf stretches: Lean your hands and shoulders against a wall, put one foot forward and bend that knee, then extend the back foot until there’s a nice stretch in the back of the calf. (Stretches are also a good way to PREVENT plantar fasciitis.)
Stretching before you get out of bed in the morning. To do a plantar fascia stretch, cross one leg over the other knee, grasp the toes of the top leg, and gently pull toward you. Place the other hand on the bottom of the foot to feel the band tighten – hold this stretch for about 10 seconds and repeat up to 20 times per side. Some experts recommend using the hand on the sole of the foot to gently massage the plantar fascia.
Wear Better Footwear
Wearing a shoe with a thick sole and plenty of cushioning (especially in the heel) can greatly relieve pain.
Custom orthotics may help relieve pain by altering the biomechanics of your foot – these are prescribed by a podiatrist or another specialist. They are made specifically for your feet.
If being overweight is part of what put you at risk for plantar fasciitis, losing weight may help reduce the pain.
Night splints can be a very effective option
Most people sleep with their toe pointed, wearing a splint to keep the foot flexed with the toes closer to the shin can help the muscles stretch out over time - helping to reduce strain on plantar fascia tendon. However, many people find this to be disruptive to sleep.
Special taping, physical therapy massage, or other interventions from a professional may help provide support and pain reduction.
Injections of medications or shockwave therapy may be effective options, especially for people who aren’t helped by the other methods.
Remember: be patient. In the best cases, it will probably take 6 weeks to notice improvement from these methods.
How long does plantar fasciitis last?
Because it usually takes either time or trauma to cause plantar fasciitis, it can take a while to heal it too. In the best cases, plantar fasciitis pain is improved within the first week of adopting the measures above and resolves in about 6-8 weeks. Most people experience relief in 10 months or less.
If pain lasts longer than 12 months with conservative treatments and regular physical therapy, then surgery may be considered. Surgeries vary, but generally aim to increase the length of the plantar fascia or loosen the calf muscles by cutting them.
Around 90% of patients improve without the need to consider surgery, but for those who don’t, plantar fasciitis can be very frustrating. Part of the issue is that the body’s processes to heal chronic damage, like the kind in plantar fasciitis, aren’t yet well-understood. That means, doctors sometimes have a hard time knowing what the right approach is – for these people, a visit with a podiatrist is essential.