Did you feel a sharp pain in your heel with your first steps out of bed this morning? Or do you feel a stabbing in your foot when you stand up from your desk? If so, you may have plantar fasciitis.
Your pain can develop over time or appear overnight. It can be especially troublesome when it develops in people with a high level of physical activity, which is often the case. Regardless of how it shows up, it can impact your daily life and sideline you from exercise. So, it’s important to take steps (no pun intended) to reduce the inflammation and increase your comfort, says Jeffrey Wu, MD, an orthopaedic surgeon with The Christ Hospital Physicians-Orthopaedics & Sports Medicine who specializes in foot and ankle treatments.
“Pain from plantar fasciitis can have an impact on your day-to-day physical and mental health. If you’re not staying active because of the discomfort, you’re at risk for weight gain and other health problems,” he says. “By paying attention to and taking care of your feet, it’s a lot easier to take care of the rest of you.”
Here, Dr. Wu shares insights about plantar fasciitis and how you can treat your symptoms.
What is plantar fasciitis?
Plantar fasciitis is a painful condition that affects your plantar fascia tendon, the thick band of tissue that runs from your toes to your heel. It happens when that tissue becomes inflamed or worn down.
According to the National Institutes of Health, 10 percent of people between ages 40 and 60 will develop plantar fasciitis. Dr. Wu says it’s similar to tendonitis in other parts of the body.
“It’s not exactly inflammation. It’s more like a wear-and-tear, degenerative problem,” he says. “People used to call it bone spurs, but it’s not a bone problem. I tell people it’s like tennis elbow for your foot.”
What does plantar fasciitis feel like, and why does it happen?
Pain and stiffness in the bottom of your heel are the most common plantar fasciitis symptoms. Sometimes, that discomfort can stretch across the arch or bottom of your foot. You’re more likely to feel these symptoms when you get out of bed in the morning or stand up after sitting for a long time. You may also feel:
It’s difficult to avoid or prevent plantar fasciitis because you rely on your feet consistently throughout the day, Dr. Wu says.
“You’re never not using your feet,” he says. “Every step you take—even in a walking boot or something similar—you’re still using your foot.”
Over time, the plantar fascia tendon can develop small tears that trigger inflammation. At that point, the root of the problem is the lack of blood flow to the tendon itself. Because that tissue has few blood vessels, Dr. Wu says healing is more difficult and takes longer.
Are runners at high risk for plantar fasciitis?
Dr. Wu says plantar fasciitis typically appears when people increase their activity. So, runners are at high risk for developing the condition. It can affect anyone who starts a new exercise program or increases their overall activity. But long-distance runners can be particularly susceptible. So, if you’re training for a long-distance race like a marathon or half-marathon, pay close attention to your feet.
Runners aren’t alone, though. Anyone can develop plantar fasciitis, he says. In addition to running and your age, a few factors may increase your risk. These include:
Any other exercise: Stress on your foot from repeated exercise increases the likelihood of this condition.
Job: Occupations that keep you on your feet—like construction or teaching—boost your risk, particularly if you’re standing on a hard surface.
Obesity: The pressure from extra weight can tax your plantar fascia tendon.
Pregnancy: Although temporary, the added weight can impact your feet.
Your foot structure: Flat feet, a high arch or an atypical walking pattern can inflame your plantar fascia tendon.
How can you treat plantar fasciitis?
A physical exam and evaluation of your symptoms are typically all that’s needed to diagnose plantar fasciitis. In some cases, your doctor may request an X-ray or MRI to rule out a stress fracture. This usually isn’t necessary if your symptoms are clinically consistent with plantar fasciitis.
The good news is that this condition is treatable. Sometimes, if you’re fortunate, plantar fasciitis goes away on its own. It usually requires some work, though. Taking an over-the-counter non-steroidal anti-inflammatory like ibuprofen and slowing down—but not stopping activity—are helpful first steps, Dr. Wu says. Then, you can add these conservative treatments one by one:
Stretching: Stretch your calf and foot for five minutes four to five times a day.
Icing: Ice the bottom of your foot for 15 minutes a couple times a day to help reduce the inflammation.
Rolling: Roll a tennis ball, golf ball, or for added benefit – a frozen water bottle, under the arch of your foot for two to three minutes to loosen your plantar fascia, then rest and repeat.
Adding arch supports: Put arch supports (like the ones found in running stores) in your shoes to help distribute stress and pressure evenly across your foot.
Selecting different shoes: Choose a shoe with a stiffer, more substantial sole. These shoes provide more support. In addition, running stores can analyze the way your foot hits the ground and offer advice on the best shoe for you.
Cross-training: Take a break from running and pick a different activity that puts less stress on the arch of your foot. Biking, elliptical training, rowing or swimming are good exercise options that will keep you fit while your plantar fascia tendon heals.
If those treatment methods don’t work after several weeks, Dr. Wu suggests talking to your doctor about:
Physical therapy: A trained physical therapist can show you additional exercises to stretch your calf, foot and Achilles tendon. They can also teach you how to wrap your foot with a supportive bandage if necessary.
Steroid injections: Steroid medication like cortisone can reduce inflammation. A combination of the medication and a bit of local injury from the needle itself can encourage more blood flow to your plantar fascia tendon and lead to healing.
Surgery: Although surgery is an option for plantar fasciitis, it is uncommon. Your doctor will only suggest it if all other treatment options have failed.
Plantar fasciitis can be extremely painful, but Dr. Wu says it’s important to remember that it is something that can improve and also resolve.
“It’s a very manageable issue,” he says. “There are a lot of ways we can address your pain. We will work with you to find the treatment option that reduces your discomfort and gets you back on your feet.”
Talk to one of our foot and ankle specialists if you experience plantar fasciitis symptoms.