The plantar fascia is the ligament connecting the heel bone to the toes and, thus, supporting the arch of the foot. When this flat band of tissue becomes weak, inflamed or injured, the resulting condition is known as plantar fasciitis with its primary symptom being pain in the affected foot particularly the heel when standing, walking and running.
Excessive strains placed on the plantar fascia causes tiny tears in it. The tears can worsen until such time that inflammation in the ligament happens that, in turn, leads to heel pain. Such stresses come from various factors including:
- Excessive pronation when the feet have an unusual inward roll when walking
- Abnormalities in the foot’s structure such as high arches and flat feet
- Prolonged periods of walking, standing and running especially on hard surfaces like concrete
- Poorly-fitting or worn-out shoes
- Tightness in the calf muscle or Achilles tendon
Certain individuals are also at high risk for the development of plantar fasciitis including:
- Older individuals between 40 and 60 years of age
- Women especially those who wear high heels for prolonged periods
- Track and field athletes, ballerinas, and dancers
- Factory workers, teachers and policemen, thus, the alternative term of policeman’s heel
In the case of high heels, these shoes make the Achilles tendon contract and shorten in an extreme manner. The tissue around your heel is then subjected to excessive strains.
In most cases, the heel pain closely associated with plantar fasciitis has a gradual yet noticeable onset. It can start with just one foot and then spread to both feet until such time that walking, much less running and jumping, become unbearable even for short distances. It can also develop in both feet at the same time, thus, worsening the pain.
The pain is described as being like a stab with a small knife or a large pin in the heel of your foot – or feet, as the case may be. You will observe that the pain is triggered by or made worst when taking the first few steps after sitting down or lying down for prolonged periods. You may also feel pain after standing for prolonged periods such as when your work as a teacher demands it.
Fortunately, plantar fasciitis can be treated with conservative treatments within a few months. Your doctor will recommend the following:
- Medications to alleviate heel pain such as non-steroidal anti-inflammatory drugs
- Corticosteroids lessen the inflammation in the ligament; these can be delivered either via solution or injection
- Physical therapy exercises to stabilize and strengthen the plantar fascia, Achilles tendon, and lower leg muscles
- Night splints and athletic tapes to stretch the calf and support the bottom of the feet, respectively
- Arch supports to evenly distribute pressure on your feet
You may also require extracorporeal shock wave therapy or surgery when the abovementioned conservative measures fail to do the job but this is rare.
The most important aspects of dealing with plantar fasciitis are self-care measures at home. These include putting your feet up, applying ice on the affected area, and taking up cardio exercises with little to no impact (i.e., swimming and biking instead of jogging).