PLANTAR FASCIITIS

by Cathy Petra, MS, ATC, Sanford Clinic Orthopedics & Sports Medicine

Our feet are an amazing part of our bodies that we often take for granted and abuse…until they hurt. The foot is a complex arrangement of 26 bones, and numerous ligaments, tendons and muscles. The feet not only function as supports and a means of propulsion, but also are important in maintaining our balance as they have to adapt quickly to the varied surfaces upon which we walk, run and jump.

One very common foot ailment is plantar fasciitis — otherwise known as heel spur syndrome. The primary symptom of this condition is stiffness and pain in the arch and/or under the heel. Often pain is worse first thing in the morning, after sitting or with periods of prolonged walking or standing. If a heel spur is present, typically that is not the cause of the arch or heel pain.

The plantar fascia is a thick fibrous band of tissue, much like a tendon, that runs from the heel to the ball of the foot. Its function is to raise the arch of your foot as it pushes off the ground. This fascia can become irritated or torn if your foot flattens too much as you walk, you have tight calves, your shoes do not fit well and do not provide adequate support, or if you suddenly increase activity levels. Other factors that can increase your risk of injury include obesity, inadequate warm-up before activity, poor physical conditioning, aging and prolonged standing.

Treatment for plantar fasciitis includes gentle stretching and strengthening of the foot and calf, hot and cold treatments, and getting proper arch support in your shoes. Stretch the bare foot by first bending the knee, grasp the ball of the foot with both hands and pull the foot towards the knee. You should feel a gentle stretch in you arch. Hold this position for 10 seconds. Repeat four times. Do this four to six times per day. Next, sit with your leg straight out in front of you. Place a belt or towel around the ball of your foot and gently pull on the towel to bring your foot toward your knee. You should feel this stretch in your calf and perhaps a little in your arch. Again, hold this position for 10 seconds. Repeat four times. Do this four to six times per day.

sport shoes

To strengthen the arch muscles, place a towel on a smooth floor (this doesn’t work well on carpet). Sit in a chair with your toes on the towel and curl your toes to draw the towel towards your heel. Repeat until the foot feels tired, rest a minute and repeat a second time. This strengthening activity should be performed every other day.

In addition, hot and cold treatments are useful to loosen up the arch and promote healing. To do these treatments, you need two 20 oz plastic bottles. Fill one with water and put it in the freezer. At treatment time, remove the first bottle from the freezer; fill the second bottle with hot water from the tap. Place both bottles on the floor. Roll the arch of the foot over the cold bottle for three to five minutes. Follow this by rolling the arch over the hot bottle for three to five minutes. This treatment should be done at least once daily, you may repeat this as needed.

Plantar fasciitis can be a stubborn condition and typically, the longer it has been present, the longer it will take to get better. You should anticipate about 25% improvement four weeks after starting the exercises and stretches, especially if you also improve your foot wear and provide support to the arch. Once your feet are feeling better, continue to perform the stretches and exercises to prevent future problems.

  1. Naylor B.L., Black J.R., Jacoby R.P., Trepal M.J. (2002). Foot Care: Plantar Fasciitis. The StayWell Company.
  2. Safran M., Stone D.A., Zachazewski J (2003). Plantar Fascitis (Heel Spur Syndrome). Instructions for Sports Medicine Patients. Elsevier Science (USA) 576-577.
  3. Arnheim D.D., Prentice W.E. (2000). Principles of Athletic Training. McGraw Hill (Boston) 465-468.