Plantar Fasciitis

by Carolyn Poston, PT

Plantar fasciitis (inflammation of the plantar fascia) is the most common cause of heel pain. It is commonly seen in many groups of people including runners, people who stand and walk for longer periods of time, especially on hard surfaces, individuals who have put on weight, and those who have excessively high arches or flat feet.

The plantar fascia is a ligament-like structure that extends from the heel bone to the base of the toes, acting like a band of support on the bottom arch of the foot. Pain is usually brought on by micro trauma or microscopic tears occurring anywhere along the fascia or where the fascia inserts on the heel bone. Typically, pain is at its worst first thing in the morning when the feet hit the floor. It can also be noticeable at the beginning of an activity and generally improves as the body warms up.

Plantar fasciitis can be caused by tightness in the calf muscle, improper biomechanics with athletic activities, and by poorly fitting or worn out shoes. It may take six to 18 months for symptoms to resolve completely. However, symptoms have been shown to resolve more quickly when the time between onset of symptoms and the beginning of treatment is as short as possible.

Physical therapy treatment of plantar fasciitis consists of an active approach that includes stretching to the calf muscles and fascia. Biomechanics and shoes are assessed and recommendations are made based on the assessment. Modalities of ice are ultrasound are used to reduce pain and inflammation when needed. In more severe cases, night splints may be needed and your physician may choose to use cortisone injections and oral medications for pain, as well as prescribe orthotics to be worn in your shoes.