Probably the most common cause of heel pain. Symptoms come on gradually and are often worse first thing in the morning. The plantar fascia is the tissue under the foot which forms the arch. Treatment includes rest, reducing pain and inflammation and stretching exercises.
Symptoms of plantar fasciitis consist of a gradual onset of pain under the heel which may radiate forwards into the foot (foot arch pain). There may be tenderness under the sole of the foot and on the inside of the heel when pressing in. The pain can range from being slightly uncomfortable to very painful depending on how badly it is damaged.
Pain is usually worse first in the morning because the foot has been in a relaxed position all night and the plantar fascia temporarily shortens. After walking around this usually eases as the tissues warm up and gradually stretch out. When the condition is present, similar periods of moving around following inactivity such as sitting for long periods can also trigger the pain.
Plantar fasciitis is an overuse injury caused by repetitive over-stretching of the plantar fascia which is is thick band of tissue / tendon that runs under the foot leads to possible inflammation and thickening of the tendon. Through overuse the fascia can become inflamed and painful at its attachment to the heel bone or calcaneus. The condition is traditionally thought to be inflammation, however this is now believed to be incorrect due to the absence of actual inflammatory cells within the fascia and degeneration is thought to be a more likely cause.
It is more common in sports which involve running, dancing or jumping. Although overuse is ultimately the cause of injury, there are a number of factors which can increase the likelihood of developing it including overpronation, a high arched foot, tight calf muscles, poor footwear, being overweight and previous injury.
Plantar fasciitis exercises
Exercises to stretch the plantar fascia and calf muscles take priority initially over strengthening. Calf with the leg straight (to target the larger gastrocnemius muscle) and with the knee bent (targeting the lower soleus muscles) are done 3 to 5 times are day, holding the stretches for up to 30 seconds at a time. The plantar fascia stretch is done by pulling the foot an toes upwards aiming to feel a stretch in the arch of the foot. Rolling the foot over a ball can also help stretch underneath the foot.
Strengthening exercises are not normally needed, however scrunching a towel up with the toes can get the small muscles of the foot working.
Deep tissue sports massage can help as part of a treatment for plantar fasciitis by stretching the plantar fascia. I use a number of various techniques including Myo fascia release techniques and fascia blaster tools and offer lots of self-help advice to combat this problem.