You swing your legs over the side of the bed, ready to hit the ground running. But as you land on your foot, a sharp pain shoots through your heel. Initially it’s intense, but as you hobble along it seems to dissipate—and by the time you leave for work it’s vanished. But you notice it again the next morning, and the next.
If this sounds familiar, you may be suffering from plantar fasciitis, or PF, which causes the plantar fascia tissue that connects your heel to your toes to become inflamed. The condition affects more than 2 million Americans each year, most commonly people aged 40–60. PF and its more chronic cousin, plantar fasciosis, can have a number of causes: an injury to the foot or ankle; shoes that don’t provide enough support for your feet; or standing for long periods of time, especially on cement. Very often, PF can develop when the three main calf muscles become tight. Activities such as running, tennis, dancing, or basketball are common culprits, especially in “weekend warriors,” which in turn cause the Achilles tendon to tighten and pull on the plantar fascia. You can also develop PF from wearing shoes with a zero or negative heel—and also, paradoxically, from high heels!
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PF usually occurs in just one foot, but it can develop in both feet simultaneously. If the pain lasts more than a couple of days, it’s best to see a doctor (ideally a podiatrist) for a definitive diagnosis. A doctor can usually diagnose it from the location of your pain and your history of physical activity, but they may also do an x-ray to rule out a fracture or a heel spur, which is a growth of bone on the calcaneus, or heel bone.
Dr. Lori K. Paragas, DPM, FACFAS, a podiatrist in Hamden, Connecticut, sees many cases of PF in her practice. Paragas finds that it’s most common in those who wear shoes lacking ample support. “Finding a good, over-the-counter arch support or insert is key,” she told The FruitGuys Magazine, adding, “You can also try custom-molded orthotics.”
The sole of your foot is referred to anatomically as the “plantar surface,” while “fascia” is another term for connective tissue. The fascia can get injured or become tight or inflamed. The first indication is usually pain at the front of the heel bone that occurs when you begin to walk after sitting or lying down. It may feel like a hot poker in the bottom of your heel or like you have a pebble in your shoe; it may lessen as the tissue warms up, which explains why many of us are able to ignore it, until it gets intolerably painful.
Early Treatment is Key
Treatment of PF depends on its cause, but initially involves decreasing the inflammation and discomfort, and then determining what may have instigated it. In almost all cases, Dr. Paragas notes, you’ll want to look at how your shoes might be involved. It’s helpful to bring your most-worn shoes and your sports shoes when you see your doctor. Dr. Paragas typically puts her patients on NSAIDS (nonsteroidal anti-inflammatory drugs, such as Advil ) and gives them a stretching protocol focused on the calf and foot muscles. “I also have my patients avoid working out on the treadmill in an inclined position, or hiking/running up hills, as those movements can exacerbate the condition,” she says.
Acupuncture or massage—focusing on the foot, ankle, and calf areas—can also be helpful, as can yoga or Pilates with an experienced teacher. At-home treatments you can try include: stretching and strengthening exercises; rolling your foot on a golf or tennis ball; and rolling on a frozen water bottle for 10 to 15 minutes a day to reduce inflammation.
Dr. Paragas cautions that most cases of PF can take weeks or months to resolve, so you need to be patient and stick to your home protocol. And it’s not uncommon for it to resolve, but then return months or years later. If at-home treatments fail, Dr. Paragas may recommend laser treatment or a steroid injection. Rarely does she find that surgery is necessary.
Matt Giraud, a brand strategist from Portland, Oregon, in his early 50s, tried everything to resolve his painful plantar fasciitis, before he eventually opted for surgery ten years ago. “The surgeon cut about a quarter of the fascia on both feet, lessening the tension but still allowing the fascia to function,” he told The FruitGuys Magazine. “Now, I’m totally symptom-free.”
Don’t Ignore Foot Pain
So next time you feel a sharp pain in your foot, don’t just ignore it or write it off as a sign of being out of shape or aging. Consider whether you might be experiencing PF and consult a doctor if you have any concerns. If diagnosed and treated early and consistently, PF shouldn’t interfere with your weekend hikes or tennis games, and you’ll be able to dance the night away pain-free.
T. J. Ford is a health and fiscal fitness coach, educator, and writer who usually eats dessert first. She lives with her husband and their cat, Kiwi, in Portland, OR.