Q&A: Plantar Fasciitis

What is plantar fasciitis?

Plantar fasciitis is inflammation of the plantar fascia. The plantar fascia is a strong band of tissue (like a ligament) that stretches from the heel (calcaneus) to the middle of the foot bones (metatarsals). The main functions of the plantar fascia are to support the arch of the foot and absorb shock in your foot.



How can I get plantar fasciitis?

Here are a few factors that can increase your risk of plantar fasciitis:

  • Prolonged use of improper footwear, meaning wearing shoes that do not have good heel cushion and arch support
  • Frequent long distance running
  • Active occupation where you are always on your feet such as a factory worker or restaurant server
  • Active men and women between the ages of 40 and 70
  • Occurs more frequently in women more than men
  • Flat feet meaning you naturally have very little or no arch in your foot
  • Having a very high arch 
  • Tight Achilles tendon, which is the tendon that attaches the calf muscle to your heel
  • Obesity
  • Pregnancy


How do I know that I have plantar fasciitis? 

Here are common symptoms of plantar fasciitis:

  • Heel pain
  • Pain with weight bearing, especially in the morning
  • Pain after prolonged sitting/standing
  • Pain after activity
  • Tenderness at the heel (calcaneus)
  • Pain when stretching the big toe
  • Mild swelling
  • Decreased range of motion with dorsiflexion (moving the foot up)

In order to accurately diagnose plantar fasciitis, imaging (x-rays, ultrasound scan, etc) can see if there is thickening or swelling in the plantar fascia. Another way is to visit your local direct-access physical therapist @ Vital Step PT, where they can perform a few diagnostic tests. These diagnostic tests can include assessing how you walk and the range of motion/strength of your foot, palpating or using their hands to feel for any inflammation or tenderness, and the Windlass test. The physical therapist can perform this test by bringing your foot and great toe into extension (moving the foot and big toe up towards the ceiling) to see if that motion causes pain in the heel.



How can I treat plantar fasciitis?

Although fascia tissue takes quite a long time to heal, there are ways to speed up recovery.  If the plantar fasciitis happened just recently (in a few hours to a day), then below are some conservative treatments:

  • Rest: Avoid excessive walking, standing or other activities that would stretch the plantar fascia
  • Choose proper footwear: Avoid walking barefoot on a hard surface initially. Make sure that you wear cushioned heeled shoes with a good arch (sneakers over sandals). This also means avoid old and worn out shoes.
  •  Visiting your local direct access physical therapist @ Vital Step PT for:
    • Personalized and appropriate exercises that will stretch the plantar fascia and strengthen the foot and ankle muscles.
    • Professional stretches for the plantar fascia and the muscles around the ankle.
    • Pain modalities or techniques to relieve pain such as estim, ultrasound and ice massage.
    • Graston technique to break up scar tissue or adhesions that can build up over time.