Plantar fasciitis is caused by inflammation or degeneration within the thick specialized ligament in the bottom of the foot – known as the plantar fascia. It is this ligament that supports the arch of the foot, so when it is compromised or inflamed, it can be extremely painful.
As we walk, jog, or go up steps, the plantar fascia acts as a shock absorber. While the exact reasons for someone to develop plantar fasciitis may differ, the common causes include overuse, lack of support, or a degeneration or injury in the ligament.
Those with plantar fasciitis may experience heel or arch pain that is generally worse after an activity or after sitting and then standing again. While it can affect anyone, we commonly see it affecting those who are overweight, who do not wear supportive shoes, and who run or stand for long periods of time.
While plantar fasciitis may affect each individual differently, there are many tips I give my patients to overcome the pain.
First, when the pain starts, make sure to rest, take a pain reliever like ibuprofen, and apply ice to the painful area.
Second, there are exercises you can do to help stretch the plantar fascia ligament and the surrounding muscles. One exercise is to stand on a stair, with the ball of the foot on the step, and the heel hanging off the step. Gently lower yourself down toward the heel until you feel it stretching your calf and foot muscles.
Another exercise that might help is to freeze a half-full water bottle and roll it under your heel and arch while you are seated. Do this multiple times throughout the day to keep the ligament stretched so it doesn’t get injured during daily activities.
Third, buy supportive shoes. Avoid bare feet or wearing just socks around the house. Look for nonflexible sneakers and arch supports.
The final suggestion I have is if you are beginning a weight-loss program by walking, starting gradually is the key. Too much walking, not enough rest days, changing your distance or terrain, or pushing too hard can frequently cause plantar fasciitis. By controlling your weight, you are less likely to experience foot and heel pain, but I do recommend cross training. This means not doing the same exercise every day; alternate walking with swimming, biking or the elliptical.
For most patients, plantar fasciitis can be controlled without surgery, but it depends on how long they have experienced pain and if the pain started due to an injury to the ligament itself. If you have been having pain for longer than three weeks, and you have tried the above suggestions, it may be time to see a board-certified foot and ankle specialist.
Claire Capobianco, DPM, FACFAS, is board certified in forefoot, rearfoot and ankle surgery, and is fellowship-trained. She is affiliated with Beebe Healthcare and employed at Orthopaedic Associates of Southern Delaware’s Foot and Ankle Center. For more information on Orthopaedic Services at Beebe, go to www.beebehealthcare.org/ortho.