The deep plantar fascia is a band of connective tissue which runs from the calcaneus (the bone that forms the back of the heel) to the toes. (The term plantar (NOT "planter") refers to the sole of the foot.) The front past of the plantar fascia actually splits into five smaller bands, one for each toe. The fascia tightens as the toes extend while walking, which helps raise the arch and rotate the foot as you take a step with that foot.
Plantar fasciitis is an inflammation of the plantar fascia. It is a common cause of foot pain in adults -- it occurs most often between ages 40 and 60 years -- but often occurs in younger people, especially runners, ballet dancers, and people who regularly do aerobics. The exact cause is not known, but suspected risk factors include:
These are suuspected risk factors; so far there is little firm evidence that any of these actually cause plantar fasciitis. Plantar fasciitis usually happens by itself, but may also occur with certain kinds of arthritis or with poor bone development due to malnutrition.
We suspect plantar fasciitis in any person with pain in the heel, especially if there is point tenderness over the heel when the planter fascia is stretched. When we examine a patient with heel pain, we first dorsiflex the toes (bend them upward) to stretch the plantar fascia, and then press on the sole, over the plantar fascia, trying to find tender points on the fascia.
4 out of 5 cases of plantar fasciitis resolve within a year or so with little or no treatment. There are several simple measures that help relieve the pain:
Exercises, including stretching exercises for the foot and ankle, may be helpful. Nonsteroidal anti-inflammatory drugs such as Motrin® may help relieve pain, but should not be used for more than 2-3 weeks unless your doctor prescribes a longer course.
In rare cases more drastic treatment, such as steroid injections, may be needed. Surgery has been used to treat persistent or severe plantar fasciitis, but recovery from surgery may take some time and the pain may persist for a while. It is also possible for an experienced massage therapist to relieve plantar fascitis by massaging the feet; it is thought that proper (not necessarily amateur) foot massage helps the sole become more flexible.