Updated: Apr 24
THE PLANTAR FASCIITIS SELF-TREATMENT SERIES:
Causes and symptoms of plantar fasciitis (this article)
That pain in your heel may well be plantar fasciitis. It’s one of the most common foot injuries, after all. The good news is that you can fix it yourself with some simple equipment in most cases, if you can pinpoint the cause. In this article, we describe the most common symptoms of plantar fasciitis, how the plantar fascia functions, and what causes it to become injured.
In this article:
We have also made a video about this.
Typical plantar fasciitis symptoms
The typical symptoms of plantar fasciitis include:
Pain and stiffness in the heel and/or inside arch of the foot (see picture below).
Pain when you put your foot down and walk first thing in the morning.
Your pain decreases with movement, but then increases if you spend too much time on your feet.
Increased pain when you walk after sitting still for a while.
When you press under your foot with your finger, you find a painful spot to the inside of the heel bone where the back end of the plantar fascia attaches. This painful area may extend into the arch of the foot (see picture below).
What the plantar fascia does
The first step to understanding the causes of plantar fasciitis is to get a basic idea of how the foot works.
The plantar fascia is a thick band of sinewy white tissue under the arch of your foot that runs from your heelbone to the ball of your foot.
It is part of a system in the foot and lower leg that keeps your body stable as you stand, walk or run. The system consists of muscles, tendons, bones, ligaments, and the plantar fascia.
The role of the plantar fascia is to keep your foot from collapsing while there’s weight on the foot. Picture it as a cable that runs between the heel and the toes and tightens when you place weight on your foot. It also plays an important part in transferring load from the heel to the ball of the foot while you walk or run.
What causes plantar fasciitis?
Plantar fasciitis is caused when the load that the plantar fascia has to work against is too high, causing it to develop micro-tears and inflammation.
The amount of force the plantar fascia has to deal with can be influenced by activity (e.g. running vs. walking), your weight, surfaces (e.g. lawn vs. pavement), foot arch height (high vs. flat arches), muscle tension (tight calves), as well as weak muscles.
The injury can happen suddenly or over time through repetitive strain.
Common causes of plantar fasciitis include:
The most common cause of plantar fasciitis I see in my clinic is when your shoes do not support your foot arch enough and you’re on your feet for a long time. Examples are a long shopping trip, going sightseeing in flip-flops while on holiday, or running an endurance race.
If you gain a lot of weight, it will increase the force through your feet and the plantar fascia will have to work harder to keep the foot arch from collapsing.
Your calves or other muscles in your legs are too tight.
If you suddenly take up running and overdo it, or if you do something like sprint to catch a bus while wearing the wrong shoes.
If you walk or run on very hard surfaces. Softs surfaces help to absorb some of the shock created when you run or walk, but if you do it on hard surfaces the plantar fascia has to deal with all of it.
If other muscles in your lower body, all the way up to your glutes, aren’t strong enough and do not control the leg or absorb their share of the shock during running.
Now that you know what could cause your plantar fasciitis, let’s take a look at how to go about treating it yourself.
Or, if you're looking for a rehab plan, check out the Plantar Fasciitis rehab plan in the Exakt Health app. I've helped to design the app to guide you through the rehab process from the moment your foot becomes painful all the way back to your sport.
How we can help
Need more help with your injury? You’re welcome to consult one of the team at SIP online via video call for an assessment of your injury and a tailored treatment plan.
We're all UK Chartered Physiotherapists with Master’s Degrees related to Sports & Exercise Medicine. But at Sports Injury Physio we don't just value qualifications; all of us also have a wealth of experience working with athletes across a broad variety of sports, ranging from recreationally active people to professional athletes. You can meet the team here.