Plantar Fasciitis Causes, Symptoms & Treatment Options

Plantar fasciitis is inflammation of the plantar fascia ligament, located on the bottom of the foot. The plantar fascia is an important ligament of the foot that connects your heel with each of your toes. This ligament is what gives support to your arch. When the plantar fascia becomes irritated or damaged, this can lead to inflammation, called plantar fasciitis. Inflammation can cause pain that makes it difficult to walk and participate in athletic activities.

The plantar fascia acts as a shock absorber for impact, strain, and stress that we put on our feet each and every day. For athletes, this pressure is exaggerated, as the impact from running and jumping places a great amount of stress on the ligament. When too much strain is placed on the plantar fascia, it can develop small tears that become inflamed and cause 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

Plantar fasciitis generally presents itself as pain on the bottom of the heel. It may be sharp at times and a dull ache at other times. Pain in the heel is most commonly felt when:

• Taking the first steps in the morning
• Getting up from a seated position
• Performing extended weight-bearing activities

Sometimes, you may feel pain in the arch, although this is less common.

If you’re experiencing mild to moderate pain in the heel that does not resolve after a few weeks, make an appointment to see an orthopedic specialist. During the appointment, you’ll be asked to describe your pain. Your doctor will then examine your foot for tenderness and to rule out other possible causes of heel pain, such as a stress fracture or nerve entrapment syndrome. You may also need to get an x-ray to look for bone spurs. Very rarely, a magnetic resonance imaging (MRI) scan may be needed to confirm the diagnosis.

Roughly 98.5% of cases of plantar fasciitis resolve with conservative care. Conservative treatment options include:

• Silicone heel wedges, soft arches, and possibly custom • orthotics (a type of shoe insert) to provide more support to the foot
• Modifying activities until symptoms improve
• Achilles tendon stretching
• Plantar fascia stretching

Severe cases of plantar fasciitis may require immobilization and physical therapy. If your symptoms persist for several months, your doctor may recommend a cortisone injection to help relieve inflammation and pain.

Try these exercises to help address your condition:

Below is a PDF of the Exercise Program

Plantar Fasciitis

In rare cases, plantar fasciitis may require surgical intervention to relieve symptoms. You may need surgery if your symptoms persist for six to 12 months while doing 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 in order to release tension in the plantar fascia.

Since most of the time the treatment for plantar fasciitis is conservative, you can return to play rather quickly. However, sometimes plantar fasciitis symptoms can last for months even with appropriate conservative treatment.

If you have surgery for plantar fasciitis, recovery time will depend on whether you had open or arthroscopic surgery. Following an open plantar fascia release or gastrocnemius recession procedure, you will be required to wear a protective brace or boot for two to three weeks. Recovery will involve physical therapy, but you will not be allowed to run or jump for at least three months following the procedure. Before you can return to full athletic activities, your doctor will expect you to have regained full range of motion and strength without any pain.