Medical FAQ: Plantar Fasciitis

Plantar fasciitis, an inflammation of the thick tissue that connects the heel to the bone, affects more than 3 million people a year. After initial onset, treatment is difficult. Mike Fuentes, Fitness Coach at Pure Austin, explains why this condition affects so many people and what we can do for prevention.

Q+A with Mike Fuentes, PT, DPT, ACSM-CPT, Fitness Coach, Pure Austin 

What is plantar fasciitis?
Plantar fasciitis, also called Plantar Fasciopathy, is pain caused by degenerative irritation of the plantar fascia (or aponeurosis) at its origin on the calcaneus. In short, the plantar fascia is a dense fibrous connective tissue structure originating at the medial tuberosity of the calcaneus that extends through the medial longitudinal arch into individual bundles. It provides tension and support through the arch and shock absorption when the heel contacts the ground.

What are the signs and symptoms of plantar fasciitis?
They often include insidious onset of heel pain, especially pain and stiffness in the heel within the first few steps when rising in the morning or after a period of inactivity. Patient history may reveal a recent increase in activity prior to the onset of the plantar fasciitis.

What causes plantar fasciitis?
Plantar fasciitis is commonly found in sports like running, long distance walking, tennis, and basketball as well as in people whose jobs require long periods of standing. Repetitive micro trauma with heel strike, fat pad atrophy that occurs with age, nerve entrapment, prolonged weight bearing on hard surfaces, unaccustomed running or walking, inappropriate shoe wear, and decreased ankle dorsiflexion are all possible causes.

What are the best ways to prevent or reverse plantar fasciitis?
Activity modification, appropriate changes in training volume, proper shoe wear, and working with your healthcare provider as soon as heel pain starts to affect your daily activities or training are best modes of prevention. 

What are the best exercises and therapy for plantar fasciitis?
Stretching the plantar fascia and Achilles tendon, soft tissue mobilization, manual therapy, specific exercise to address the joint dysfunction, addressing intrinsic foot muscle strength, and taping are other possible methods of treatment. Night splints may be advised for those individuals struggling with plantar fasciitis for over six months. Corticosteroid injections should be used with caution as relief from this form of treatment can be short-lived and is associated with difficulties such as plantar fascia rupture and fat pad atrophy. 

Your advice to anyone with plantar fasciitis?
The information provided here is a great starting point to understanding your heel pain. But, I would highly advise a person to seek out a licensed healthcare professional to conduct a thorough evaluation, properly diagnose, and develop an appropriate treatment plan to return them to their previous level of function. If treated early, a person can get back to his or her normal routine in around eight weeks. However, if left untreated, the pain and rehab process may take several months to resolve.