The plantar fascia is a fibrous band or aponeurosis located underneath the foot that extends from the base of the calcaneus to the phalanges¹. Its primary role is to support the arch of the foot, allowing for efficiency when walking through the absorption and release of energy through the windlass mechanism. Plantar fasciitis is an inflammation of the plantar fascia and is a condition frequently encountered in clinical practice, especially among runners. The inflammation of the plantar fascia can be caused by an intense effort, or more commonly because of repeated trauma at its origin at the medial tubercle of the calcaneus¹. The latter places excessive stress on the plantar fascia, causing small tears, inflammation and pain underneath the foot. Pain may also be worse in the morning when first getting out of bed. This is because while sleeping, the plantar fascia is in a shortened position for a prolonged period of time. When you take your first steps, the plantar fascia is suddenly stretched, causing pain².
Common Causes of Plantar Fasciitis
- Faulty biomechanics of the foot (i.e. overpronation of the foot)¹
- Flat feet/high arches¹ ² ³
- Being overweight²
- Inappropriate footwear ²
- Sudden increase in training volume (i.e. increasing running frequency, intensity and/or distance) ² ³
- Decreased flexibility of the gastrocnemius, soleus and hamstring muscles³
- Decreased strength of the gastrocnemius, soleus and intrinsic foot muscles³
How To Manage Your Plantar Fasciitis² ⁴
- Rest: Refrain from exercise or physical activity that aggravates your pain initially (i.e. running). Avoid prolonged standing and walking for long periods of time so as not to aggravate the pain. You can gradually return to exercise or physical activity when there is no pain with daily activities such as standing, walking and going up or down the stairs.
- Medications: Please consult your doctor to inquire about any medications you can take to help relieve your plantar fasciitis.
- Cold packs/ice: Place a cold pack underneath your foot for 15-20 minutes at a time, multiple times a day, as needed. Wait a minimum two hours between icing periods. Another alternative is very gently rolling a frozen water bottle underneath your foot. The cold pack will help relieve your pain and reduce any inflammation caused by the injury.
- Gentle stretching: gentle, pain-free stretching of the calf and plantar fascia can also help reveal your pain. For detailed instructions on how to do so, please click here.
- Consult your physiotherapist: A physiotherapist will perform a comprehensive evaluation to determine the causes of your plantar fasciitis. Treatment may include modalities for pain, myofascial release of tight muscles, manual therapy to optimize mobility at the joints of the lower extremity, stretching and strengthening exercises for the ankle and foot to optimize efficient foot biomechanics, as well as arch taping to provide temporary support to the arch of your foot to decrease some of the stress on the plantar fascia² ⁴.
How To Prevent Plantar Fasciitis From Recurring
Proper footwear: shoes with thicker soles provide more cushioning and support to the arch of the foot, relieving some tension from the plantar fascia¹ ² ³ ⁴.
Orthotics/taping: Pre-made or custom-made orthotics may be helpful to correct faulty biomechanics of the foot and provide additional support to the arch of the foot² ⁴.
Consult your physiotherapist!
Surgery: Typically only considered after no improvements with 12 months of conservative treatment. Include procedures such as a gastrocnemius recession or plantar fascia release⁴.
Anthony Teoli MScPT
If you have any questions or concerns regarding your plantar fasciitis, please consult your doctor and/or physiotherapist. If you have any questions or concerns regarding the content of this blog post, you may contact me directly at firstname.lastname@example.org.
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DISCLAIMER: This blog is not meant for diagnostic or treatment purposes. It should not substitute for professional diagnosis and treatment. This blog was not created to provide physiotherapy consultations, nor was it created to obtain new clients. The content of this blog is a resource for information only. This blog was created to serve as an information resource for both the general population and health professionals. For any further questions or concerns regarding plantar fasciitis, please consult your doctor or physiotherapist
1. Bogla, L. A., & Malone, T. R. (2004). Plantar Fasciitis and the Windlass Mechanism: A Biomechanical Link To Clinical Practice. Journal of Athletic Training, 39(1), 77-82. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC385265/pdf/attr_39_01_0077.pdf
2. Canadian Physiotherapy Association. 2014. Plantar Fasciitis. Retrieved from: http://physiocanhelp.ca/wp-content/uploads/2014/04/PlantarFasciitis_EN.pdf
3. Young, C. C. (2012). Plantar Fasciitis. Medscape Reference. Retrieved from: http://content.partnerunning.com/praresourcedocs/6_injurypreventionandtreatment/plantar_fasciitis.pdf
4. OrthoInfo. (2010). Plantar Fasciitis and Bone Spurs. American Academy of Orthopaedic Surgeons. Retrieved from: http://orthoinfo.aaos.org/topic.cfm?topic=a00149