Plantar Fasciitis

Overview

The plantar fascia acts as a natural shock absorber, helping the foot handle the daily impact, strain, and stress from walking, running, and jumping. In athletes, repetitive high-impact activities place extra stress on this ligament. Excessive strain can lead to small tears, inflammation, and heel pain, resulting in plantar fasciitis.

• How the Injury Occurs: Plantar fasciitis develops when repetitive stress or sudden increases in activity create micro-tears in the plantar fascia, leading to inflammation and pain in the heel.
• Common Everyday Causes: Daily activities such as prolonged standing, walking on hard surfaces, wearing unsupportive shoes, or carrying excess body weight can also contribute to plantar fascia strain and heel pain.

Athletes with the following risk factors are more likely to develop plantar fasciitis:

• Tight Achilles tendon: Reduced flexibility increases tension on the plantar fascia during movement.
• Tight calf muscles: Limited calf mobility forces extra strain on the foot’s arch.
• Wearing shoes that don’t provide enough arch support: Inadequate footwear fails to absorb shock and stabilize the foot, contributing to ligament stress.

Plantar fasciitis is most common in these sports:

• Baseball: Frequent running and sudden sprinting put repeated stress on the heel.
• Basketball: Jumping and quick directional changes overload the plantar fascia.
• Football: Explosive movements and hard surface play increase heel impact.
• Running: High mileage and repetitive heel strikes strain the ligament.
• Soccer: Sprinting, cutting, and kicking motions intensify foot stress.
• Lacrosse: Rapid running, twisting, and stopping add repeated strain on the plantar fascia.

What causes Plantar Fasciitis?

The plantar fascia acts as a shock absorber for the impact, strain, and stress we put on our feet daily. This pressure is exaggerated for athletes, as the impact of running and jumping greatly stresses the ligament. When too much strain is placed on the plantar fascia, small tears can develop that become inflamed and cause heel pain. Athletes with the following risk factors are more likely to develop plantar fasciitis:

• Tight Achilles tendon
• Tight calf muscle
• Wearing shoes that don’t provide enough arch support

Plantar fasciitis is most common in these sports:

• Baseball
• Basketball
• Football
• Running
• Soccer
• Lacrosse

Symptoms

Plantar fasciitis typically causes pain on the bottom of the heel, which can range from a sharp sting to a dull, aching discomfort. Common situations that trigger heel pain include:

• Morning foot pain: Sharp discomfort often occurs with the first steps after waking.
• Getting up from a seated position: Pain may appear after standing following periods of rest.
• Extended weight-bearing activities: Walking, running, or standing for long periods can worsen discomfort.

In some cases, pain may also be felt along the arch of the foot, though this is less frequent than heel pain.

Non-operative treatment

Approximately 98.5% of plantar fasciitis cases improve with conservative care. Initial treatment options focus on reducing strain, supporting the foot, and relieving inflammation, and include:

• Silicone heel wedges, soft arches, or custom orthotics: Provide extra support and cushioning to reduce stress on the plantar fascia.
• Modifying activities: Temporarily limiting high-impact movements helps the ligament heal.
• Achilles tendon stretching: Improves calf flexibility, reducing tension on the plantar fascia.
• Plantar fascia stretching: Directly stretches and relieves stress on the inflamed ligament.

In more severe cases, immobilization and physical therapy may be recommended. If plantar fasciitis symptoms persist for several months, a cortisone injection can be administered to reduce inflammation and relieve heel pain.

Try these exercises to help address your condition:

Below is a PDF of the Exercise Program

Plantar Fasciitis

Surgical Treatment

In rare cases, plantar fasciitis may require surgical intervention to relieve symptoms. You may need surgery if your plantar fasciitis symptoms persist for six to 12 months in spite of conservative treatment. There are two surgeries that are used for plantar fasciitis treatment. Each procedure can be performed arthroscopically (through a tiny incision) or using an open technique (through a larger incision). These procedures are:

• Plantar fascia release: A small part of the fascia is cut to release tension and therefore relieve symptoms.
• Gastrocnemius recession: A small cut is made in the gastrocnemius tendon, loosening and lengthening the muscle to release tension in the plantar fascia.