Chronic Plantar Fasciitis

Plantar fasciitis is a condition that causes pain on the bottom of the foot and heel, that is often defined by pain during the first steps of the morning, and pain in the heel upon weight-bearing. Pain also occurs at the start of the activity and goes away with use. It often returns after a long rest and then restarting activity.

What Is the Plantar Fascia?

The plantar fascia is a long, thick, and tough band of tissue that provides support for the medial longitudinal arch of the foot. The plantar fascia is stretched and the arch flattens slightly to absorb the impact each time the heel impacts the ground. This fascia is not very flexible and such repetitive stretching from impact can result in small tears in the fascia.

Causes of Plantar Fasciitis

Typical causes of plantar fasciitis include overstretching a tight plantar fascial band, consistent overuse, and irritation that results in microtears to the fascia at its calcaneal (heel bone) attachment.

Predisposing factors may include:

• Flat feet
• High arches
• Excessive pronation from not having arch support while walking or running
• Obesity or sudden weight gain
• Tight Achilles tendons from unstretched calf muscles
• A sudden increase in leg activity intensity, time, or type
• Wearing high heeled shoes for years – this shortens the calf muscles, Achilles tendon, and plantar fascia, so when you walk without heels the tendons hurt
• A sudden change in running or walking surface
• Prolonged standing or weight-bearing
• Damage to the soles of the feet

What does it feel like?

Plantar fasciitis typically feels like a stabbing pain in the bottom of your foot near the heel. The pain is usually worst with the first few steps after awakening, although it can also be triggered by long periods of standing or getting up from a seated position.