Plantar Fasciitis: Understanding, Prevention, and Care

Plantar fasciitis is a common foot condition primarily affecting the plantar fascia, a thick band of connective tissue located on the sole of your foot, connecting your heel bone to your toes. It provides arch support and absorbs shock from the ground, acting as the foot's natural shock absorber. When the plantar fascia becomes inflamed due to overuse or excessive stress, it leads to pain. 

Who is Prone to Plantar Fasciitis?

The following groups are more susceptible to developing plantar fasciitis:

• Overweight Individuals: Increased body weight places greater stress on the feet.

• Individuals who Stand or Walk for Long Periods: This includes people whose jobs require prolonged standing, or those who engage in extended walking, hiking, or similar activities.

• Those who Carry Heavy Loads: This increases the burden on the feet.

• Overly Active Individuals: Especially those involved in high-impact sports like running or hiking. Without proper rest and training, the plantar fascia can become inflamed.

• Individuals with Weak Muscles or Lack of Exercise: Insufficient strength in the foot and calf muscles can lead to the plantar fascia bearing more stress.

• Improper Footwear:

  • Ill-fitting shoes: Shoes that don't provide adequate support and cushioning.

  • Prolonged wearing of high heels: Especially those with high, thin heels, as they alter weight distribution and increase the load on the plantar fascia.

  • Shoes with overly hard or thin soles: Lacking shock absorption.

• Excessive Foot Massages: Inappropriate or overly vigorous foot massages can irritate the plantar fascia, worsening inflammation.

• Women: Clinical statistics show that women have a slightly higher incidence rate than men, which might be related to footwear choices or physiological structure.

• Individuals with Flat Feet or High Arches: These structural abnormalities can alter the stress patterns on the plantar fascia, making it more prone to injury.

• Aging: As we age, the elasticity and repair capabilities of the plantar fascia may decrease.

Typical Symptoms of Plantar Fasciitis

The most characteristic symptoms of plantar fasciitis are:

• Sharp Heel Pain Upon Waking: This is the most distinctive feature. When you first step out of bed in the morning, you'll experience a sharp, stabbing pain in your heel. This happens because the plantar fascia shortens overnight, and stretching it upon getting up causes pain.

• Increased Pain After Rest: After prolonged sitting or rest, the heel pain worsens when you stand or walk again.

• Relief with Activity, but Worsening with Excessive Activity: Typically, the pain may subside slightly after some activity, but if you continue walking or exercising for extended periods, the pain will intensify again.

• Mild Swelling on the Inner Side of the Heel: Some individuals may observe mild swelling or tenderness on the inner part of the heel's sole.

Daily Care and Rehabilitation for Plantar Fasciitis

Treating and recovering from plantar fasciitis requires patience and comprehensive daily care. Here are some important recommendations:

1. Reduce Foot Strain

• Manage Weight: Losing weight is one of the most effective ways to alleviate pressure on your feet.

• Avoid Prolonged Standing or Walking: Especially during periods of pain, try to minimize activities that involve long periods of standing or walking, such as hiking, long walks, or jogging.

• Rest When Needed: When your feet feel uncomfortable, rest immediately to avoid overuse.

• Use Assistive Devices: In cases of severe pain, consider using crutches to reduce weight-bearing on the affected foot.

• Reduce Carrying Heavy Loads: Try to avoid carrying heavy objects for extended periods to lessen the burden on your feet.

2. Choose Appropriate Footwear and Insoles

Selecting the correct shoes and insoles is crucial for recovery from plantar fasciitis:

• Opt for Shoes with Good Cushioning: Prioritize athletic shoes, running shoes, or shoes with thick, soft padding.

• Ensure Proper Shoe Fit: Shoes should be comfortably snug, not pinching your toes, and preventing your foot from sliding inside.

• Provide Arch Support: The inside of the shoe or accompanying insoles should offer good arch support. This effectively distributes pressure across the sole and reduces strain on the plantar fascia.

• Avoid Flat Shoes and High Heels: Try to avoid shoes with overly flat or hard soles, as well as thin high heels, as these increase pressure on the sole of your foot.

• Use Orthotic Inserts: For individuals with arch abnormalities (like flat feet or high arches), consult a professional to get custom-made or over-the-counter orthotic insoles with arch support. These can effectively improve biomechanics, prevent heel spurs from forming, and prevent recurrence, with a success rate of over 90%.

• Avoid Barefoot Walking on Hard Surfaces: Especially at home, wear slippers or soft-soled shoes to reduce direct impact on your feet from hard floors.

3. Local Care

• Ice Application: For acute pain or after exercise, you can apply ice to the affected area for about 15-20 minutes, 2-3 times a day. This helps reduce inflammation and swelling.

• Heat Application: During non-acute inflammatory periods, or for daily relief, apply local heat for about 10-15 minutes, 2-3 times a day. Heat helps promote blood circulation and relax muscles and fascia.

• Warm Water Foot Soaks: Soaking your feet in warm water before bed can also help relax foot muscles and relieve fatigue.

4. Stretching and Strengthening Exercises

Appropriate stretching exercises can help relax the plantar fascia and calf muscles, while strengthening related muscle groups can provide better support. It's recommended to consult a physical therapist to learn the correct stretching and strengthening exercises, such as:

• Plantar Fascia Stretch: Sit on a chair, place the affected ankle on the opposite thigh. Use your hand to pull your toes upwards towards your shin, feeling the stretch in your plantar fascia. Hold for 15-30 seconds, repeat several times.

• Calf Muscle Stretch: Stand facing a wall, place your hands on the wall. Extend the affected leg straight back, keeping your heel on the ground, and feel the stretch in your calf muscle. Hold for 15-30 seconds, repeat several times.

• Toe Towel Curls: Place a towel on the floor and use your toes to try and scrunch up the towel. This strengthens the small muscles in your foot.

• Ball Roll Massage: Use a golf ball or tennis ball to roll back and forth under your sole, gently massaging the plantar fascia. This helps with relaxation.

5. Other Considerations

• Avoid Excessive Foot Massages: During the inflammatory phase, avoid excessive or strong foot massages, as this can worsen inflammation.

• Seek Professional Help: If the pain persists or worsens, consult an orthopedic doctor, rehabilitation physician, or physical therapist for a thorough evaluation and professional treatment, such as physical therapy, medication, or injections.