Causes and Remedies of Plantar Fasciitis

Plantar fasciitis is a common problem that’s estimated to affect about two million people every year, from runners to non-athletes. It can be caused by many things, from your foot’s anatomy to sudden trauma, or even your footwear. Recovery can be slow but is usually achieved at home without medical procedures. 

If you’ve experienced the blinding pain of plantar fasciitis in your heel, you’ll know it’s no joke. It usually attacks you like a knife when you take your first steps out of bed in the morning. If it gets bad, you’ll be in pain all day.

Want to know how best to avoid and treat it? Check out the causes and remedies of plantar fasciitis in this article.

Also, check out our article on the best running shoes for plantar fasciitis. And also our other activity based shoe recommendations if you suffer from plantar fasciitis

What Is Plantar Fasciitis?

Plantar fasciitis is a common heel injury in the connective tissue of the foot. This tissue, called fascia, runs from your heels to your toes. When it’s inflamed, it causes a stabbing pain in the heel and, sometimes, the entire foot. If it gets bad, it can be impossible for you to walk even a few steps.

Plantar fasciitis is often chronic, coming from degeneration of tissue rather than an inflammation. It’s a common condition that affects both sedentary and athletic people, with young male athletes being a particularly prominent group. However, overweight women from 40 to 60 are the most affected. 

Symptoms

Plantar fasciitis is easily recognizable to those who’ve experienced it. You’ll feel severe pain in your foot, especially with the first few steps of the morning. The pain usually goes away after a little warming up of the muscles and tissue. It might come back during the day if you’ve been sitting for a longer period. 

The pain can also get worse during the day if you’ve done a lot of activity. This might happen if your work requires you to spend hours standing up, or if you’ve been walking or running.

You’ll especially feel the pain when you’re putting weight on the heel. However, the tissue that causes the pain covers your whole foot, so the discomfort might affect it completely.

What Causes Plantar Fasciitis?

Plantar fasciitis is known as an overuse injury, meaning that it’s usually caused by repetitive strain. However, there’s more to the story. Let’s look at some of the most common causes that can make you more prone to getting plantar fasciitis:

• Trauma and strain.
• Being overweight.
• Shoes.
• Previous issues.
• Heel spurs.
• Tight muscles in the legs and feet.
• Achilles heel issues.

Trauma and Strain

Trauma to the foot, either from a sudden fall or a prolonged activity, can be the cause of plantar fasciitis. If you fell to your feet hard enough to cause some of the fascia tissue to tear, it might have been the trigger.

The strain can also be more prolonged. A sudden increase in exercise intensity, walking barefoot or standing for prolonged periods can end up causing these microtears in your fascia. Most people don’t pay attention to a slight discomfort until the damage is more advanced and acute.

This can also happen if your running or training shoes aren’t adequately cushioned. You might end up causing a strong repetitive impact on your heel without realizing it.

Being Overweight

Extra weight puts more pressure on your foot muscles and can contribute to plantar fasciitis. This is why overweight men and women are especially at risk of developing this condition.

If you’re looking to shed a few pounds I would recommend checking out our article on how to lose weight running.

Shoes

Many different kinds of shoes can contribute to you developing plantar fasciitis, from high heels to flat shoes.

High Heels

High heels are a requirement for many jobs and social situations, but they’re also problematic. Using heels tenses up not only the foot and its tissues but also the Achilles tendon and all the posterior leg muscles. They also change your walk, making it unnatural. 

This is why wearing heels, especially for longer periods, can contribute to many problems in your feet, legs and even your back.

Flats

Flat shoes that don’t provide enough support for the arch or cushion the heel might also make you develop this nasty condition. Think about those sandals or cheap trainers you’ve been using for hours on end. They might be to blame for your pain.

Flat shoes don’t affect everybody the same way. If you have other underlying conditions, such as flat feet or obesity, you’re more at risk of developing plantar fasciitis.

Small Shoes

If you’re walking or standing in shoes that are half a size too small, you might accidentally keep your foot in an unnatural position. If the muscles and tissues of your foot tense up for a longer time, you could end up with plantar fasciitis. This will also affect your gait, so you might end up developing even more problems if you aren’t careful.

Make sure you have enough room in your shoes when you’re buying them. If you’ve already bought and worn the shoes when you discover the shoes are too small, don’t force it. It’s better to have wasted the money than develop a painful, long-lasting problem.

Previous Issues

Previous problems of the foot or the way you walk are often the cause of plantar fasciitis. These are some of the more common ones.

Flat Feet 

A condition called pes planus, or flat feet, many times contributes to the development of other conditions such as plantar fasciitis. Your walk tends to overpronate, which means that your ankle will roll inwards and possibly cause you more problems in the long run.

The problems caused by flat arches are also worsened by extra weight, which puts even more pressure on your feet.

You might have had flat feet since birth, but they can also occur later in life, even as a result of aging. Some other causes of fallen arches are:

• Broken bones or damaged nerves and tendons in the foot.
• Obesity.
• Diabetes.
• Pregnancy.
• Aging.

You can easily check if you have flat feet at home:

1. Step out of the shower with your feet still a little wet.
2. Inspect the mark your feet leave on the floor or on your bathmat.
3. If it shows the full outline of your foot instead of a half-moon shape, you might have flat feet.

Check out our in depth guide to foot types and the impact it has on you if you want to find out more

Over-Pronounced Arch

On the other end of the spectrum, you might have a high arch on your feet. If it’s too high, it can end up causing an unnatural walk where your foot rolls outward, called supination. It also builds more tension in the tissues since your heel doesn’t naturally absorb shock.

High arches are usually inherited, but there are things you can do to prevent them from causing even more problems. This mostly involves good shoes that allow your feet enough room and give them adequate support.

Heel Spurs

Many times, plantar fasciitis and heel spurs are associated. However, it’s not clear if heel spurs are caused by plantar fasciitis or the other way around.

Heel spurs are a buildup of calcium or bone under the heel. They may worsen the plantar fasciitis symptoms, but they might also be relatively painless.

The same issues usually cause heel spurs and plantar fasciitis:

• Repetitive athletic strain, such as running.
• Obesity.
• Footwear.
• Problems with your gait.

Tight Leg Muscles 

You might not realize it, but your posterior leg muscles, from your hips to your hamstrings or your calves, can cause problems all the way down to your heel and foot. It can be because of a sudden increase in training or just a buildup of tension from your everyday life.

You can test your hamstring tightness at home:

1. Sit on the floor with your legs forward and your back straight, with your toes pointing up.
2. Bend from the hips to see if you can reach over the line of your toes with your hands.

Always make sure you’re stretching adequately after your workouts or a long day’s work on your feet. Reserve at least 10 minutes at the gym for it, and try to include it in your daily routine.

Take your time to stretch both the muscles at the front and the back of the legs, as well as the hips. Everything is connected, so even tightness in your lower back might be causing problems in your hamstrings. This will eventually radiate to the feet.

Consider investing in a foam roller, they’re cheap and whilst they may be a poor man’s massage they help relieve the soreness in your muscles unbelievably. Take it from a former sceptic. If you’re not sure how to use a foam roller, then check out our guide

Tight Foot Muscles

Sometimes, plantar fasciitis is even caused by a temporary flexibility issue in the foot. Do you tend to develop muscle tension in your feet when working out? There might be something wrong with your gait that makes you tense up.

Grab your foot in your hands and carefully stretch your toes up and backward. Does it hurt? Do you feel pain and tension in the arch of the foot? This might be the reason for your plantar fasciitis.

Achilles Heel Tightness

The Achilles tendon is a common source of problems for athletes and sedentary people. You might get an inflammation of the tendon, or tendinitis, if you’re putting yourself through a lot of training. This, in turn, can tighten up the tissue in your feet.

Find a mirror and look at your ankles from the back. Is there inflammation around the tendon, especially on the foot that’s giving you problems? This might be connected to your plantar fasciitis.

How Plantar Fasciitis Is Diagnosed

Usually, only a clinical examination is required to diagnose the condition. However, your doctor might choose to use an x-ray to check for fractures, bone spurs or arthritis. 

Even if you’re sure of your diagnosis at home, it’s always good to check with a doctor. They’ll detect the root cause of your problem with certainty. The more you know about your condition and its causes, the better prepared you’ll be to tackle it.

Treatments for Plantar Fasciitis

The treatments for plantar fasciitis range from non-invasive therapy and easy exercises at home to more invasive medical procedures.

At-Home Treatments

The important thing is to accept that plantar fasciitis usually has long recovery times. With some patience, you’ll be able to get rid of it for good and not get a chronic condition that will bother you for the rest of your life.

Consider these at-home treatments for plantar fasciitis:

• Rest.
• Ice.
• Footwear.
• Stretching.
• Massage.
• Sleep.
• Losing weight.
• Physical therapy.

Rest

If there’s a lot of inflammation in your foot, give it some rest. Avoid walking and running as much as you can when you’re going through a bout of inflammation.

Ice

Some people get amazing benefits from icing to bring down the inflammation when it’s particularly tough. However, when your muscles aren’t warm, you’ll likely experience more pain. To avoid this, try not to walk around for a while immediately after the cold treatment.

You can use an ice pack for 15 minutes when you get home at night, but be sure to rest afterward.

Footwear Choices

If your plantar fasciitis is worsened by a specific type of shoe, give your feet a rest from it as well. That might mean you won’t be able to use heels at work or when going out, but you’ll save yourself a lot of pain.

Examine your running shoes. Are they getting old and losing their capacity to absorb impact? Do they provide enough support for your arch? Especially if you suffer from flat feet, make sure your sneakers are the best option for your feet.

In general, try to find shoes that keep your heel cushioned. You can also add an insole for that specific purpose. What some people find useful are shoes that lift and cushion the back of the foot a bit. This helps take the pressure off, while not being as heavy for your muscles as high-heeled shoes.

Stretching

This should be a given, but always stretch your muscles after exercise. It will avoid soreness and improve your mobility in many ways, not just for plantar fasciitis. Take a good 10–15 minutes for it whenever you’ve gone out for a run or a workout.

Don’t just limit stretching to the gym. Try to include some light stretches to your morning and night routines, as well. That includes your posterior leg muscles, calves and hamstrings, as well as your feet. Consider introducing a foam roller into your stretching routine for that extra relief.

Massage

Massaging the foot muscles helps release tension. It works especially well when combined with stretching, ice and appropriate footwear.

This will likely help you if your pain is severe in the morning. Warm up your feet with some light movements and massage before stepping out of bed to ease some of the discomfort.

Sleep

One great trick to help you with foot pain issues and recover faster is to untuck your bedsheet. Tight sheets and heavy duvets will force your toes down, which will make your calf muscles work needlessly at night and end up shortening them.

If this doesn’t help, you can also invest in night splints. They’ll help you keep your foot at a 90-degree angle and give your muscles a good night-long stretch.

Losing Weight

Losing weight will help you reduce the stress on your feet. Your body weight will be more evenly distributed on your feet, and you’ll most likely find long-term relief. It’ll also help you with other issues, like possible fallen arches or gait problems.

Physical Therapy

Exercises to rehabilitate the fascia tissue and strengthen your muscles are usually helpful in getting rid of the condition. Consult your doctor to get a good rehabilitation program for your specific needs.

Medical Procedures for Plantar Fasciitis

More invasive procedures are used only when other measures haven’t improved your situation. There’s a range of different therapies that help in pain relief and heal the tissue:

• Injections.
• Shock wave therapy.
• Ultrasonic treatment.
• Surgery.

Injections

Sometimes, steroid injections are used to help relieve pain. This solution is only temporary, so it’ll be necessary to complement with other measures. It’s also not recommended for use on multiple occasions due to its possible effect on damaging the tissue.

Plasma injections drawn from the patient’s blood are also sometimes used for treatment. They can help regenerate damaged tissue and provide a more lasting solution.

Shock Wave Therapy

Mechanical high-energy sound waves can be used to help the fascia tissue heal. This is a quick and non-invasive therapy option that stimulates your blood flow and your body’s natural healing mechanisms. However, it’s not necessarily effective in all cases. 

Ultrasonic Technology

Vibrating ultrasound energy can be used to break up damaged tissue. It’s then suctioned out with a needle-like probe inserted into the heel.

This procedure isn’t as invasive as surgery, but might not be available everywhere.

Surgery 

If all else fails, and the pain is severe, surgery is an option. It involves cutting the fascia tissue partially and can be performed endoscopically on local anesthesia. It can also be performed as an open surgery, which will make recovery times longer.

How Long Does It Take to Cure Plantar Fasciitis?

While plantar fasciitis is common, it’s not always an easy situation to resolve. Curing it often takes from 6 to 18 months, which can make you feel frustrated.

Don’t despair, though. Starting treatment and changing your habits right away will shorten this timeline. Make sure to give your feet the rest it needs to help you get your strength back sooner. 

Bottom line

Plantar fasciitis is a common condition, and it’s possible to recover from it completely. The good news is there’s a lot you can do on your own at home.

Rest, ice, massages and stretching will help most people and are simple to do. Remember to pay extra attention to your footwear and sleeping habits to make sure you’ll be free of pain.

Visit your doctor to make sure the diagnosis is for plantar fasciitis and to get the right instructions for you. If the pain doesn’t go away with less invasive therapy, even surgery is an option.

And, if you are unlucky enough to be afflicted by plantar fasciitis, then I would recommend you also take care to select the right type of footwear for the activity that you are doing.

Please also remember this is just a guide, if you are suffering from plantar fasciitis or any type of injury always speak to a doctor or a licensed medical professional.