Plantar fasciitis is one of the most common foot ailments, affecting approximately 10% of the adult population. It usually occurs due to overuse of the feet from repetitive activities such as long distance running, hiking, walking, or poor form during exercise. The plantar fascia is a web-like, thick, and flexible band of tissue located under your sole. It connects the heel bones to the toe bones, thus forming the arch of the foot while supporting you as you walk. Due to continuous wear and tear, that tissue will eventually lead to inflammation around the area. And when that happens, you will end up with a burning sensation whenever you step on the ground after a period of rest. Plantar fasciitis usually affects the dominant foot. However, it can also spread to the other foot if not treated on time.
Most people with plantar fasciitis complain of stinging pain at the bottom of the heel when they wake up and take a few steps. The pain usually worsens whenever you lift something heavy or stand for long hours. Other people complain of tenderness around the midfoot area as well as swelling and inflammation. The pain then reduces whenever you lift your feet off the ground or cease repetitive movements. Climbing stairs can also be a challenge, due to stiffness around the heel. If you have observed any or a combination of the above symptoms, there is a high chance you have plantar fasciitis, or it’s about to strike, and it’s advisable to seek professional medical help as soon as possible.
Causes and Risk Factors
Most forms of heel pain occur due to a continuous inflammation process, which changes the structure of the tissue around the heels. When you develop plantar fasciitis, your heel fascia will experience tiny micro tears, due to overuse or injury. And when that happens, there will be swelling and inflammation in the heel fascia. Consequently, the body will naturally try to deal with the problem by healing those micro tears. As a result, the heel pad will increase in thickness, while losing its flexibility as well as the ability to absorb shock and its range of motion. Therefore, the heel becomes unable to withstand your weight. Every time you try to move, you will experience a stinging underfoot pain. Naturally, you will try to avoid this pain by changing your posture or remaining inactive. It then becomes a vicious cycle, leading to further tissue damage. If only one foot had been affected, there is a high chance that plantar fasciitis will also affect the other one, due to resultant posture changes.
Some people are more vulnerable to plantar fasciitis than others. For instance, if you are an athlete or you frequently exercise, then overusing the plantar fascia can lead to this condition. Also, if your job involves walking or standing for long periods, such as nurses, waitresses, teachers or industrial workers, you are also at risk of plantar fasciitis. Furthermore, exercising without proper shoes or adopting the wrong form also exposes you to this condition. Other risk factors include being overweight, biomechanical foot problems, running without proper shoes or wearing worn out shoes while training, as well as a history of lifestyle diseases smoking and a poor diet. You also expose your feet to plantar fasciitis if you start an exercise too fast without giving your feet enough time to adjust. If you have very flat feet or too high arches, then you also at risk of plantar fasciitis and wearing shoes without proper support can escalate the problem. For this reason, it is advised to act preventively and always wear shoes with good support. Especially when you are working a job that requires you to stand up for long hourse, such as a nursing job.
Plantar Fasciitis vs. Heel Spurs
Some people tend to confuse heel spurs with plantar fasciitis since both conditions have similar symptoms. As noted earlier, plantar fasciitis leads to inflammation of the fascia while heel spurs is a protruding bony material at the heel’s surface. However, both conditions alter the formation and operation of the connective tissue at the bottom of the foot. Apart from that, you can also have both conditions at the same time, although it’s a rarity. If you have plantar fasciitis, the stress on the plantar fascia will lead to swelling, irritation, as well as a weak and fragile arch. On the other hand, heel spurs will only lead to pain and inflammation. Heel spurs, just like plantar fasciitis occurs due to poor walking or running form, wearing improper shoes while training or continuous training on hard surfaces without proper footwear.
Managing the pain that comes with plantar fasciitis can sometimes feel like a full-time job. However, if your work involves standing for long hours or you are a professional athlete, then it’s not easy to work or exercise through pain. Luckily, numerous alternative treatments are available, which you can use to alleviate the pain that comes with plantar fasciitis while avoiding invasive treatments such as surgery. The first thing to do when you have been diagnosed with plantar fasciitis is to ensure you give your feet ample rest. You need to avoid repetitive routines that trigger and increase the pain. Your feet will require at least three weeks of ample rest for the damaged tissue to heal completely. However, the exact period of rest needed differs from one person to the other.
While you are resting, you can stretch your feet through low impact activities such as bicycling and swimming, which helps to promote blood circulation to your feet. Applying an ice pack to the swollen or inflamed area will also help to reduce the pain. Place the affected foot on a raised platform and then apply the ice packs for approximately 20 minutes, at least 2 to 4 times every day. The swelling and inflammation will normally subside after 2 to 3 days if you are religiously following the above routines.
After that, you should massage the heel gently and then proceed to heat therapy, using essential oils. Essential oils have been used for thousands of years to minimize or alleviate inflammation. Apart from reducing inflammation, massaging your feet with warm, essential oils will promote blood flow while speeding up the healing process. It will also break up any scar tissue that has hardened in the heel, making it a great treatment for heel spurs as well. Use a circular hands motion to massage your feet for at least 15 minutes every day. You can use coconut or olive oil, mixed with various essential oils such as thyme oil, rosemary oil, lavender oil and rose oil to minimize swelling and pain. You should also consider roller massage since it helps to alleviate pain in the feet. You just need to position a golf ball beneath your feet, and then roll your foot over it for approximately 15 to 20 minutes every day. A roller massage promotes blood flow to the foot while breaking down improperly healed tears.
Apart from massage, you should also consider stretching exercises. Research shows that stretching exercises are effective treatment options for people with plantar fasciitis. Ensuring your calf, ankle muscles and Achilles tendon muscles are flexible can reduce the pain that comes with plantar fasciitis. Furthermore, stretching can reduce tissue adhesion, improve range of motion and improve form – which are all beneficial when you are dealing with plantar fasciitis. According to a study conducted by the Baltalimani Osteopathic Training and Research Hospital, over 96% of people with plantar fasciitis noted significant improvements after undertaking various foot stretches within 5 months. The same study also revealed that plantar fasciitis symptoms improved immensely after exercising and stretching at least twice per day. The Mayo Clinic, together with the American Orthopedic Foot and Ankle Society recommends various stretches and exercises including towel stretches, toe stretches, squat stretches, thumb massage, as well as Achilles tendon stretch. You can perform most of these exercises at home, without the need for additional help or advanced equipment.
Wearing proper footwear will also go a long way in minimizing the plantar fasciitis pain and inflammation. As you probably know, your choice of footwear plays a vital role towards your posture, walking or running form. Shoes can also determine your ability to endure pressure and force on your feet. Therefore, if you experience consistent pain and pressure on your feet, then it’s advisable to consult a podiatrist or a physical therapist. These specialists will check your foot measurements, shape, and other alignments, and then recommend the best footwear for your feet.
The best shoes for plantar fasciitis will offer adequate arch support as well as exceptional cushioning thus lowering the risk of injuries and pain as you work or exercise. Also, these shoes should also have a spacious toe box, thus ensuring your toes have ample room to relax. If you are a fitness enthusiast or you regularly participate in physically demanding activities such as running, then you need to purchase running shoes for plantar fasciitis. In addition, it’s highly advisable to change your pair of shoes after covering approximately 500 miles or when you notice they are not providing the amount of cushioning and support as they used to before. If you have to wear sandals, then you should choose sandals with arch support or those designed for people with various foot conditions.
Avoid wearing high heels or walking barefoot for long periods, since you will be placing additional pressure on your foot, leading to more pain and discomfort. If the shoes you have purchased don’t provide the required levels of support and cushioning, then you should consider buying a pair of custom orthotics. Your physical therapist or podiatrist might also recommend a pair of specialized splints, which will stretch the arch of the foot and the calf. You can even wear these splints at night, without experiencing any form of discomfort. Splints help in keeping the Achilles tendon and the plantar fascia in a lengthened position, thus increasing flexibility. Heel cups are also a great option. They ensure even distribution of pressure under the arches, thus minimizing underfoot pain. Other alternative treatment methods to consider include Ayurveda and acupuncture.
Maintaining a healthy BMI of between 19 and 25 can also help to reduce the load and strain on your feet. For instance, if you have a high body weight than your legs can support, then you might end up with various foot issues, including plantar fasciitis. You should also consider eating anti-inflammatory foods if you are experiencing persistent pain on your feet. Apart from that, getting sufficient sleep as well as exercising will also go a long way in weight control and maintenance. Some of the best foods for plantar fasciitis include vegetables, fresh fruits, green juices, raw fruits, probiotic foods, wild-caught fish, seeds, and nuts as well as healthy proteins derived from free-range chicken. You should always opt for organic foods as much as you can.
While this condition is not normally severe, it can escalate when left untreated for long, thus restricting your movement and minimizing your productivity. If alternative treatments and anti-inflammatory, over-the-counter drugs are not working, then a health specialist will recommend medical treatments, depending on the extent of your condition. Some of the available medical treatments include corticosteroid injections, extracorporeal shock wave therapy, and surgery. However, surgery is not always recommended, since it can lead to bleeding and other infections. On the other hand, corticosteroid injections can weaken the plantar fascia tissue. If your doctor has recommended surgery to treat plantar fasciitis, then it’s advisable to seek a second opinion on the same, since it’s quite an invasive procedure.
Are you worried that you will not resume your normal lifestyle due to plantar fasciitis? Well, you don’t have to. The good news is that most people with this condition can enjoy full recovery even by using natural remedies. Approximately 90% of people with plantar fasciitis can recover within two months of treatment. However, it’s always advisable to take some time off from all strenuous activities, such as standing for long hours, training or exercising. Also, you should keep track of any symptoms that you notice during the treatment period and then inform your healthcare provider. And most importantly, ensure you are always wearing the right type of footwear depending on the activity you are undertaking, whether you are running, walking, jogging or working.