Plantar fasciitis

How to tell if the pain in your feet is plantar fasciitis

Plantar fasciitis (also known as plantar fasciosis) is thought to be due to inflammation of the thick tendinous structure that runs under the foot from the base of the heel to the toes. (Medical conditions that end in ‘itis’, such as tonsilitis, arthritis or colitis are so named due to their trade mark inflammation.) However, it’s now thought that degeneration through small repeated injury of the plantar fascia, rather than inflammation, is the cause of this particular condition, therefore the shift in terminology to “fasciosis”.

The plantar fascia is a thick band of tissue under the foot

The plantar fascia supports the long arch of your foot, and acts as a shock absorber during weight bearing. Together with the Achilles tendon and calf muscle, the fascia stores energy for push off in walking or running.

It’s one of the most common running injuries — accounting for about 10% of foot trauma. But it’s also common in people who don’t run.

Common causes of plantar fascia pain

It’s often caused by repeated small injuries to the plantar fascia during weight bearing exercise. For example if you:

  • Stand for long periods of time
  • Engage in excessive walking or running, especially if you’re not used to it
  • Suddenly increase your running volume, speed or change surfaces
  • Are overweight
  • Spend a lot of time sitting, for instance if you drive a lot, or sit in front of a computer
  • Wear poorly supporting footwear (this is particularly evident in the summer months when pumps or flip flops are worn)
  • Have tight calf muscles or a tight Achilles tendon

However, sometimes there is no apparent reason for the onset, particularly in older people. It is often wrongly called a heel spur, which is an outgrowth of bone on the heel, not necessarily related to this condition.

The plantar fascia provides shock absorption and propulsion for walking and running

How to tell if you have plantar fasciitis/ fasciosis

This painful condition can affect any shape of foot — high arch, low arch or moderate. It usually presents with pain under the foot on weight bearing. The pain is commonly felt under the heel, particularly on the inside of the heel bone. It’s often painful to touch and feels like you are walking over a pebble, or have a permanent bruise.

Stiffness and pain are very common, particularly first thing in the morning. The stiffness is also felt after being still for some time, such as after watching television, or driving.

The pain can be in one foot only, or both, and in non-runners tends to affect people in their 5th and 6th decades due to tendon and tissue changes. The condition can present with or without accompanying inflammation.

Once your condition is diagnosed, the good news is there’s a lot you can do to help yourself recover from the pain and discomfort in your foot or feet. See the next blog for information on how to do so.