Last updated date: 11-Mar-2024

Medically Reviewed By

Medically reviewed by

Dr. Btissam Fatih

Medically reviewed by

Dr. Lavrinenko Oleg

Originally Written in English

Plantar Fascia

    Plantar fascia refers to the flat tissue band or ligament that links the heel bone to the toes. It provides support to the foot arch such that if you strain the plantar fascia, it becomes swollen, weak, and inflamed or irritating. This causes pain on the bottom of the foot or heel when walking or standing. 

    Plantar fasciitis is thus the most popular cause of heel pain. It’s more common among middle-aged individuals, although it can also affect young people, especially athletes and soldiers. Furthermore, it can occur on one foot or both feet. 


    Common Triggers of Plantar Fasciitis 

    Plantar fasciitis is most likely to affect active men and women aging between 40 and 70. It also affects significantly more women, unlike men. Besides, plantar fasciitis is common in pregnant women, especially in the late stages of pregnancy.

    If you are obese or overweight, then you are more likely to develop plantar fasciitis. This is because of the high pressure on the plantar fascia ligaments, which is particularly common if you gain weight drastically.

    If you run long distances, you might be more susceptible to plantar fascia issues. Moreover, you may still be at risk if you have a physically demanding job that requires you to be on your feet frequently. Examples of such jobs include working in a factory or serving in a restaurant. 

    Plantar fasciitis can develop if you have structural issues with your feet, including extremely high arches or flat feet. Plantar fascia pain can also occur due to tight Achilles tendons, which connect the calf muscles to the heels. Plantar fasciitis may sometimes develop by putting on shoes with soft soles and insufficient arch support. 

    Heel spurs are not always the cause of plantar fasciitis. Doctors initially believed that heel spurs induced discomfort in individuals with plantar fasciitis; however, this is not the case. 


    Signs and Symptoms of Plantar Fascia 

    The most common symptom of plantar fasciitis is pain around the bottom of the heel or the bottom of the mid-foot. It typically impairs only one foot, but it may also affect both. Plantar fasciitis causes pain that progressively worsens with time. This pain may be mild or serious. A burning or aching sensation may be felt on the bottom of the foot, spreading outward from the ankle, for certain people. 

    The pain is typically worst, especially in the morning when getting out of bed or when you've been sitting or lying down for a long time. Due to heel stiffness, climbing stairs can be extremely difficult. 

    Increased inflammation and irritation may cause pain to flare up after an extended exercise. Plantar fasciitis patients normally do not experience discomfort during the activity but instead feel the pain afterward. 


    Risk Factors of Plantar Fascia 

    Despite the fact that plantar fasciitis can occur without an actual cause, there are certain factors that can elevate the chances of developing it. They are as follows:

    • Age: People aged between 40 and 60 years old are at a high risk of developing plantar fasciitis.
    • The mechanics of the feet: A high arch, flat feet, or an irregular walking pattern may all influence how weight distributes while standing. This can exert additional strain on the plantar fascia.
    • Some types of physical activities: Long-distance running, aerobic dance, and ballet dancing, are all activities that put too much tension on the heel as well as attached tissue. This can lead to plantar fasciitis. 
    • Obesity: Too much weight puts additional strain on the plantar fascia.
    • Occupations that need you to be on your feet for a more extended period: The plantar fascia may be damaged if you spend the majority of the working hours standing or walking, especially on hard surfaces. Teachers and factory workers have increased risk. 


    Plantar Fascia Diagnosis 

    The first diagnostic procedure for plantar fascia is a physical examination. It involves checking for tenderness around the foot as well as the precise location of the plantar fasciitis pain. This is usually to ensure that the pain is not a result of another foot issue. 

    The doctor can tell you to flex your foot while pushing on the plantar fascia during the evaluation. This helps determine if the pain worsens as you flex and improve when you point the toe. Through this, they can also identify if you have any minor swelling or reddening. 

    Furthermore, the doctor will check the following to determine the strength of the muscles and the health of the nerves; 

    • Reflexes 
    • Muscle Mass
    • Sensation Of Touch And Vision
    • Coordination 
    • Balance 


    Imaging tests

    In most cases, plantar fascia tests are not necessary. To ensure that another issue, including a tension fracture, is not cause of pain, the physician can recommend magnetic resonance imaging (MRI) or x-ray. 

    An X-ray can reveal a spur (a piece of bone protruding from the heel bone). The bone spurs were initially responsible for heel pain and were surgically removed. However, most people with bone spurs on the heels do not experience any heel pain. 


    Plantar Fasciitis Treatment

    The first mode of treatment is usually done at home using anti-inflammatory drugs, which is accompanied by lots of rest, ice, and the use of braces. Other prevalent treatment forms include;

    • Medications

     Certain pain relievers, including naproxen sodium and ibuprofen, can alleviate pain inflammation, discomfort, and pain associated with plantar fasciitis. 

    • Injection 

     If symptoms persist, even after the trial of home treatment, then a corticosteroid injection is administered directly into the affected ligament. The doctor uses an ultrasound to identify the ideal area of injection. An injection is not the only way of administration as corticosteroids can be applied directly to the heel skin or foot arch. Next is a painless application of an electric current that allows the drug to permit into the muscle.

    • Physical therapy 

    Plantar fasciitis can be treated using physical therapy, which is significant because it stretches the Achilles tendons and plantar fascia. Workouts build up leg muscles, steady your movement and alleviate the weight on your plantar fascia. 

    • Extracorporeal shock wave therapy 

    Extracorporeal shock wave therapy 

    If all other alternatives are non-productive and the pain persists, then extracorporeal shock wave therapy is suggested by your doctor. It still hasn’t been recognized to alleviate symptoms of plantar fasciitis. In addition, it causes pain and has multiple side effects. They include inflammation, contusions, and numbness. This wave therapy includes sound waves bombarding your heel to kindle curing in the ligament. After the trial of all the above treatment methods and the pain persists, the next option would be surgery.

    • Night splints 

    A therapist might recommend the use of a splint. It involves a patient wearing the splint when sleeping, which in turn helps in stretching the calf and arch of the foot. When worn overnight, it helps in the stretching of the Achilles tendon and plantar fascia as the splint holds them in a stretched-out situation.

    • Orthotics 

    In order to aid in the uniform distribution of pressure in the feet, a doctor is likely to recommend a medical device. This includes the custom-fitted arch or off-the-shelf supports.

    • Ultrasound tissue repair 

    The use of ultrasound technology is used in the treatment of plantar fasciitis and soft tissue problems. The procedure comprises taking imaging tests to conclude the location and extent of the damage. Next, the physician makes a small incision, and a probe tip is directed with the help of ultrasound imaging. It vibrates rapidly and breakdown the damaged plantar fascia tissue, which then gets suctioned out. The entire procedure takes just a couple of minutes, and the complications are few.

    • Surgical operation 

    Surgery becomes an alternative when the pain gets so severe, and all prior methods have been ineffective. It can be an open procedure or a minor incision that is administered with a local anesthetic. It involves the separation of the plantar fascia from the heel bone, which helps relieve tension, have the heel spur removed entirely, or have a portion of the plantar fascia detached. A surgeon can use all the above surgeries to accomplish the best results.


    Plantar Fasciitis Exercise 

    Plantar fasciitis can be relieved and even avoided through gentle stretching. Stretching the calves as well as the plantar fascia loosens the muscles and relieves heel pain. 

    It's critical to rest from such workouts, including running, to allow the plantar fascia to regenerate. Swimming or other moderate exercises will help you keep fit while also alleviating heel pain. If you begin running again, take it slowly at first.

    To prevent the pain from recurring, take a break and stretch during exercise. Also, try to stretch before starting the workouts. Plantar fasciitis stretches are simple to do. Just a few popular props are required, including a chair and a foam roller or a frozen water bottle. 

    The following stretches and exercises can help you with the plantar fasciitis recovery process; 

    Heel raises: This exercise requires one to stand on their toes then slowly lower back on the heel while supporting a wall. Carry out two or three sets; one is needed to go up and down on repeat until your feet are exhausted. Performance of this exercise causes strength build up in the muscles, and after repeated exercising, you can, with time, stand on one foot. Further progress is to stand on one foot with the heel on the edge of a step, then progress to lowering back on your heel.  

    Calf stretching: In this exercise, you should be upright with one foot in front while the one is in the back and standing on a wall. With a back straight, bend your front knee and get into a lunge from your hips, keeping the back leg forward and straight while the heel should be pressed down. Do this for each side and hold the calf stretch for thirty seconds.

    Towel curl: While seated, a towel is placed on the floor just under the painful foot. In this exercise, one only needs to curl their toes inwards, towards their bodies, working towards crumpling up the towel.

    Rolling pin: Place the feet on the floor while sitting in a chair. Roll the bottom of your foot over a rolling pin or frozen water bottle to loosen and relax the plantar fascia. Perform this exercise for at least two or three minutes.

    Stretch your toes: Cross the affected foot on the opposite knee while sitting in a chair. To stretch the base of the foot, pull back on the toes. As you massage the bottom of the foot, hold it for about 10 seconds. Do this at least three times more. 

    Towel curling: Put a towel on the floor beneath your sore foot while sitting on a chair. After that, curl the toes into the body as you scrunch up the towel with your hands. Do this for at least ten times more.


    Plantar Fascia Release 

    When you have a regular range of motion in your ankle but are still experiencing heel pain, the doctor can suggest a partial release technique. The plantar fascia ligament is slightly cut during surgery to alleviate tissue stress. A more prominent bone spur can also be extracted if you have one. While endoscopic surgery is possible, it is more complex through an open incision. Furthermore, endoscopy is associated with increased nerve damage risk. 


    Other plantar fasciitis home remedies that can minimize pain and inflammation include; 

    The RICE method: 

    Holding the injured foot off the ground when the pain first occurs is helpful. The RICE approach can be applied as first aid in case of a foot injury. This technique includes; 

    • Resting the sore or painful region for some days 
    • Putting ice to the affected part for about 20 minutes at a time to ease inflammation 
    • Compressing the area using a soft wrap to minimize swelling
    • Placing the foot on some pillows to raise the injured area. This is mostly helpful when sleeping. 


    Shoe inserts

    Shoe inserts give the arch of the foot extra support. The plantar fascia becomes less stressed with inserts. This can be particularly beneficial for individuals who spend a lot of time on their feet. Arch inserts that are soft and supportive can also be useful. 

    For more details, always consult a podiatrist, a medical provider who deals with foot health.


    Anti-inflammatory drugs 

    Ibuprofen and other non-steroidal anti-inflammatory medications (NSAIDs) help to relieve both pain and inflammation. It's, however, essential to follow the directions on the package or seek medical advice before taking this drug. Other people notice an improvement in the symptoms after taking an NSAID for a few weeks. 



    Massage has been found to help some patients with plantar fasciitis symptoms. Concentrate on massaging the arch of the foot within the region of the plantar fascia tear or injury. Massage any surrounding muscles that have become tense as a result of the pain. Other people find that massaging the arch of their foot using an ice bottle provides relaxation. 

    The fascia can take up to a whole year to recover completely and the foot pain to subside. You will, however, recover much quicker with a regular regimen of plantar fasciitis exercises. Supportive shoes and other forms of therapies can also hasten the recovery. Find out which treatments are right for your feet from a physical therapist. 


    Preventing Plantar Fasciitis 

    One can prevent plantar fasciitis by making a few lifestyle changes. Replace the athletic footwear on a daily basis and put comfortable shoes with better arch support. In case you are an athlete, each pair of shoes should be limited to about 400 to 500 miles before replacing them. 

    Consider low-impact workouts such as swimming or bicycling into your daily routine. Avoid overworking your plantar fascia by running on a regular basis. Always ensure that you stretch the Achilles tendon, calves, and plantar fascia before exercising. 

    Make every effort to maintain a healthy weight. Try to lose weight if you are overweight to relieve pressure on the plantar fascia. 


    Plantar Fasciitis Recovery 

    Plantar Fasciitis Recovery 

    Plantar fasciitis usually improves after a few months of home care. Rest, icing, as well as stretching are some of the home treatments. 

    Stabilizing the foot using tape will also help with the plantar fascia recovery. It restricts the ligament's range of motion. According to some study reports, taping the foot can also provide temporary pain and discomfort relief. 

    You may as well use kinesiology tape or zinc oxide tape. You can individually tape the foot to help with the healing process, although this can take a few practices. 


    What to Expect When You Have a Plantar Fasciitis 

    The greatest pain will occur when you first get out of bed in the morning or after a long period of sitting. Expect extreme pain to escalate as a result of high-impact activity. However, keep in mind that it's usually not long-lasting if you stick to the treatment plan. To reduce symptoms, you should have to adjust some of your daily habits. 


    Plantar Fascia Complications 

    If you overlook your heel pain, it can turn into chronic pain. This can alter your walking pattern and result in injury to the limbs, knees, back, and hips. 

    Steroid injections and other forms of treatments may deteriorate the plantar fascia ligament. This makes it vulnerable to plantar fascia rupture. 

    Surgeries to address plantar fascia are associated with various risks such as infection, bleeding, and adverse reaction to anesthesia. On the other hand, detachment of the plantar fascia can as well alter the foot and cause damage to the nerve. 


    Plantar Fasciitis in Children 

    Plantar fasciitis can develop in children just like adults due to ligament overuse or putting on old and unsupportive shoes. It's essential to consult a physician to get an accurate diagnosis and treatment because the disease tends to worsen with time. 

    To relieve any pain, inflammation, or irritation, apply ice to the child's heel. Massage may also aid in the healing process. To help the foot recover, ensure that the child gets plenty of rest and refrain from running, standing, or jumping for extended periods. 

    Remind your child to practice warm-up exercises, and plantar fascia stretches as they resume their daily activities to prevent the issue from recurring. You should also make sure they are wearing comfortable and well-fitting shoes. Another disorder that may be causing the child's heel pain is Achilles tendonitis. 


    Plantar Fasciitis versus Heel Spurs 

    A heel spur is a bone hook that forms on the calcaneus, or heel bone, of the foot. It may occur due to long-term foot tension, much like plantar fasciitis. An X-ray can be used to assess a heel spur by a podiatrist or orthopedic surgeon. 

    Most people usually believe that a heel spur is a trigger for their foot pain, which is not always the case. Heel spurs are mostly asymptomatic. 

    Plantar fasciitis and heel spurs have the same causes. Here are a few examples:

    • Worn-out or unsupportive footwear
    • Being obese or overweight 
    • Arthritis
    • Walking or running with an irregular or unnatural gait

    Heel spurs are more likely to develop if you have plantar fasciitis. Despite the fact that heel spurs do not recover without surgery, they rarely cause discomfort or other related symptoms. Due to this, surgery is rarely necessary. 

    Heel spurs may be treated in the same way as plantar fasciitis is treated. To alleviate any symptoms, you should rest, apply ice, take pain killers, and wear shoe inserts.


    Bottom Line 

    The plantar fascia involves a thick band of tissue that runs from your heel to your ball of the foot and reinforces your arch. The structures in the foot can load wrongly as a result of poor foot positioning, putting pressure on the band. An injury may also damage the fascia to the tendons around the foot or ankle. 

    Plantar fasciitis can either be a mild or chronic condition. Most patients do not always require a surgical procedure to ease the pain. Instead, the problem tends to improve over time through home remedies, physical therapies, and other medical treatment techniques.