Plantar Fasciitis: the number one cause of heel pain

When discussing the common ailments of the foot, Plantar Fasciitis is notoriously well known. In fact about 10% of the population has had or will experience Plantar Fasciitis in their lifetime. "What causes it?" and "how do you get rid of the pain?" are the questions that anyone with plantar fasciitis wants the answers to.
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What is the Plantar Fascia?

The Plantar Fascia is thick band of tissue that supports the arch of the foot. It originates at the heel and spans the wholes sole of the foot to the base of the toes. The plantar fascia helps support your arch and aids in shock-absorption.

Signs and Symptoms of Plantar Fasciitis

People who have Plantar Fasciitis experience sharp pain and/or swelling at the bottom of the heel or arch of the foot. Pain with the first few steps in the morning or first few steps after being seated for a period of time. Pain may subside after the first couple of steps but recurs with prolonged standing or increased time on their feet. As this condition becomes chronic you may find that you alter your gait to avoid pain by raising the heel off the ground or walking on the side of your foot. These compensation patters may relieve the pain temporarily but may lead to hip or knee pain if the cause of the plantar fascia pain is left untreated.

What causes Plantar Fasciitis?

• Hyperpronation or hypersupination of the feet or abnormal gait mechanics put added stress on the plantar fascia

• Increased risk factor with those who are overweight or wear inadequate footwear
• Limited ankle dorsiflexion (ability to bend your ankle up), tight Achilles Tendon or calf muscle

• Presence of a leg length discrepancy (one leg is longer than the other)
• Long distance running and jumping activities place increased stress on the heel which can predisposed you to this type of injury
• Occupations with prolonged standing or walking on hard surfaces can damage the plantar fascia
• A sudden change in your daily activities, change in footwear or sudden increase in activity level

All these risk factors add mechanical stress to the plantar fascia causing microtrauma or micro tears in the plantar fascia leading to heel and/or arch pain.

Plantar Fasciitis related Heel Pain Teatment.

First step is to find out what caused the plantar fascia to be aggravated to begin with. After completing a through biomechanical and gait analysis, we will be able to determine what biomechanical abnormalities are causing your plantar fascia to be aggravated.
Custom made orthotics can help correct faulty foot mechanics by stabilizing the medial longitudinal arch thereby reducing plantar fascia strain. Added cushion under the heel of the orthotic can help absorb impact at heel strike and raise the heel up reducing Achilles tendon strain. If it is determined that a leg length discrepancy is present a lift may be added directly to the orthotic or if greater than 1/2', the lift can be added to the shoe itself. This is called a footwear modification.
New professionally fit footwear can correct instability caused by inappropriate or worn out footwear. For the first few weeks of treatment it is imperative that you wear shoes at all times when you are on your feet. Shoes with either with built in arch support or those that can accommodate a custom made orthotic must be worn from the moment you get out of bed.
Physiotherapy and/or Massage Therapy is also recommended to address muscular imbalances and stretch out tight musculature of the lower leg.
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​Grace Bakker, C Ped (C)
​Canadian Certified Pedorthist

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