When It Hurts to Walk or Stand – Plantar Fasciitis

Plantar fasciitis (“PLAN-ter fash-ee-EYE-tus”) is a condition that feels like stepping on a nail every time the foot hits the ground. The plantar fascia is a flat band of tissue that attaches to the rear of the heel bone and stretches fanlike along the sole of the foot to the toes. Its function is to provide support of the longitudinal arch, and shock absorption.

Plantar fasciitis is caused by straining the ligament that supports the arch. Repeated strain can cause tiny tears in the ligament, causing irritation or inflammation. The pain can be at any portion of the bottom of the foot where the fascia is located. It can move around, be mild or debilitating, chronic or sporadic.

The most common cause of plantar fasciitis is tight or shortened calf muscles and Achilles tendon. Shoes with heels cause the Achilles tendon to contract and shorten, causing strain on the tissue around the heel. Running, stair climbing, and aerobics tighten the calf muscles, and also place a lot of stress on the heel bone and attached tissue.

Being overweight is often a culprit. Carrying extra pounds can break down the fatty tissue under the heel bone, and also roll the feet inward, flattening the arches.

Having flat feet increases the stretch and strain on the plantar fascia; high arches create tighter plantar tissue; both lead to poor shock absorption. Sometimes people begin walking on the front of their foot because of heel pain, which causes more tension in the plantar fascia, pulls more on the heel, and worsens the condition. Flat feet, high arches, or an unbalanced pattern of walking can adversely affect the way weight is distributed when you're on your feet, putting added stress on the plantar fascia. Foot, knee, hip or back problems may develop if plantar fasciitis changes your walking motion.

Ice helps reduce pain and inflammation. Hold a cloth-covered ice pack over the pain for fifteen to twenty minutes three or four times a day or after activity. Or freeze a water-filled paper cup and roll it over the site of discomfort for five to ten minutes.

Apply pressure to your heel by rolling a golf or tennis ball with the arch of your foot while you are standing and stabilized. This can help reduce pain and increase blood flow.

Strengthen the muscles that support your arches by picking up a golf ball or scrunching a towel with your toes.

Stretch your plantar fascia at least three times a day with these exercises:

Loop a towel or belt around the ball of your foot and pull your toes toward your nose for thirty seconds, three times in a row.

Stand facing a flight of stairs with your feet on the lowest step, your heels extending out beyond it. Slowly lower your heels below the level of the step. Hold for a count of ten, rest, repeat ten times.

Stretch the calf muscles on a step or slant board, initially three or four times daily for one minute each time. A modified stretch against the wall with the foot flat on the ground and the leg behind you, while leaning into the wall, also is adequate.

Over-the-counter pain medications may ease pain and inflammation, although they won't treat the underlying problem. Surgery may do more harm than good.

Be patient and stick with treatment; setbacks are the norm in dealing with plantar fasciitis, and preventing daily minor injuries is as important as preventing the less frequent big injuries. With treatment, you should have less pain within a few weeks, though it could take a few months to a year for the pain to go away completely.

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