Plantar fasciitis is the inflammation of the plantar fascia, a tough fibrous tissue on the underside of the foot. It may be manifested by severe pain on the bottom of the foot, especially when getting out of bed in the morning or upon weight bearing after prolonged sitting. It can affect anyone including athletes and non-athletes and men and women alike. Often there is a history of prolonged standing or poor footwear, but it can start without a specific incident.
The foot is anatomically divided into several sections. The top of the foot is called the dorsal surface. The sole of the foot is called the plantar surface. The word “fasciitis” refers to the inflammation of the fascia, which can be found throughout the body.
There are three layers of fascia. The most superficial is the layer that allows the skin to glide on the muscles and tendons. The second layer surrounds the organs and allows them to glide on each other when you breathe and move. The third and deepest layer lines the brain and spinal cord. For a good example of what fascia look like, think of the tough white fibrous sheath on one end of a beef roast.
There are four different layers of muscles along the arch of our feet. Fascia cover and support these muscles. When the fascia become tight due to trauma, injury, repetitive strain or poor footwear, they can become inflamed and cause plantar fasciitis.
To check how tight your plantar fascia is, feel the arch of your foot with one hand as you pull your big toe up toward the ceiling with your other hand. The arch should feel smooth. If a tight ridge of tissue pops up under your hand on the big toe side of the arch, you probably have some tightness.
Tightness in the calf muscles and Achilles tendon, or heelcord, can contribute to plantar fasciitis. Once you have cleared it with your doctor, doing stretches of calf muscles can help improve the mobility of the foot. Doing toe curls, in which you bring your toes up and then curl them down also helps keep your foot mobile. This is an exercise you can do inside your shoes so it is easy to do often during the day. Both applying ice and rolling your foot on a golf or tennis ball while you sit can also help mobilize the fascia.
Plantar fasciitis has also been clinically associated with general tightness of the legs and low back. Since fascia is a continuous sheath head to toe, tightness in the strong fascia in the low back and pelvic area is often seen. Also, since the feet must compensate and adjust to changes in the body’s center of gravity due to injury to the back, they often contract and spasm in an effort to help keep your balance.
Besides stretching and doing foot exercises, you must give special attention to footwear. Don’t wear shoes that are too tight. Avoid wearing high heels, since these shorten your calf muscles and pitch your center of gravity forward. If you have flat feet, make sure you find good supportive tie shoes. If you have a high arch, wear flexible shoes.
If you must stand on cement at work, try to make sure there is a rubber mat under your feet. Work boots and shoes can be fitted with soft inserts to help cushion your feet and offer some shock absorption and arch support.
If you have persistent foot pain, a visit to a podiatrist and physical therapist can be helpful. Treatments can include stretching exercises, manual therapy to loosen fascia, modalities such as ultrasound with cortisone cream, and postural evaluation to see if your foot problem is caused by an imbalance in your posture. A podiatrist may make special shoe inserts called orthotics.
Mainly, remember to take good care of your feet and get proper exercise and rest.