The plantar fascia is a ligament-like structure running from your heel to your toes. This band pulls on the heel bone, raising the arch of your foot as you push off the ground. If your foot moves incorrectly, or the arch of your foot drops, the plantar fascia may become strained. The fascia may swell, and its tiny fibers may begin to tear, causing plantar fasciitis or inflammation of the plantar fascia. over a period of time the tears at the heel may become calcified and form a heel spur.
Plantar fasciitis is often caused by poor foot mechanics. If your foot flattens too much, the fascia may overstretch and tear. This can be caused by tight heel cord, injuries, poor shoe gear or inflammatory diseases. But generally it is caused by poor mechanical function of your foot or poor bone alignment.
With plantar fasciitis, the bottom of your foot may hurt when you stand, especially first thing in the morning, or after sitting down. Pain usually occurs on the inside of the foot, near the spot where your heel and arch meet. Pain may lessen after a few steps, but it can progress to become constant.
A heel spur is an extra piece of bone that may grow near the spot where the plantar fascia attaches to the heel. The heel spur may form in response to the tug of the plantar fascia on the heel bone.
Bursitis is the swelling of a bursa, a fluid-filled sac that reduces friction between ligament and bone. Bursitis may develop if a swollen plantar fascia presses a plantar bursa against the heel bone.
X-rays of your foot may be taken to confirm a suspected heel spur of the heel bone. An ultrasound may also be done on your heel to see if the fascia is torn or thickened from the injury.
Reducing symptoms is the physician's first goal. If your pain is due to poor foot mechanics, a shoe insert may help. To relieve mild symptoms anti-inflammatory medications may be effective. Icing the affected area may also help. To reduce severe pain and swelling, your physician may prescribe medications or inject the area. Physical therapy, such as ultrasound and stretching may also be used.
To reduce symptoms caused by poor foot mechanics, your foot may be taped. This supports the arch and temporarily controls movement. Night splints may also help by stretching the fascia. If taping helps, your physician may prescribe orthotic devices. Built from plaster casts of your feet, these inserts control the way your foot moves. As a result, your symptoms should be relieved.
If surgery is needed, and other types of treatment do not control your pain, cutting the plantar fascia to release the tension can be performed. Sometimes the heel spur has to be resected.
Every time your foot strikes the ground, the plantar fascia is stretched. You can reduce the strain on the plantar fascia and the possibility of overuse by following these suggestions: lose any excess weight, avoid running on hard or uneven ground, and wear supportive shoes. Avoid wearing worn-out or flat shoes.
*photo credit: The StayWell Company / Krames Patient Education