When you have plantar fasciitis, you usually feel pain in the bottom of the heel or the arch of the foot. Some people describe the pain as feeling like a bruise or an ache. The pain tends to gradually go away once you begin walking around. With continued walking the pain may return, but usually goes away after rest. If the swollen plantar fascia irritated a nerve in the foot, pain may radiate into the ankle.
In the early stages of plantar fasciitis, the pain may go away quickly once you take weight off the foot. Over time, however, it may take longer and longer for the pain to go away. Without treatment, the plantar fascia will eventually tear partially away from the heel. The body fills the torn area in with calcium. This eventually becomes a bone and is called a heel spur.
Causes of and Risk Factors
With every step forward we take, all of our body weight comes to rest first on the heel of one foot and then gradually over the length of the foot. As the foot begins to bear weight, it flattens. This puts pressure on the plantar fascia, which has very little stretch. As we walk, the plantar fascia pulls on its attachment at the heel.
If the foot is properly aligned this pull causes no problems. If the foot is pronated - rolls outward at the ankle, the arch falls too much and there is an abnormally amount of pull on the fairly rigid plantar fascia. This causes an abnormally strong pull on the heel where the plantar fascia attach.
Something similar happens when the foot has supination (rolls inward). These type of feet are relatively inflexible, usually have a high arch and a short or unusually tight plantar fascia.
Plantar fasciitis can be caused by:
- A lack of arch support
- A sudden injury
- A tendency to pronate or supinate your feet
- An increase in activities such as running, basketball, tennis, soccer or gymnastics that involve repetitive pounding of foot
- Being overweight
- Doing a lot of walking barefooted
- Having one leg that is shorter than the other. This causes the foot on the longer leg to carry the body's entire weight longer than normal, stressing the fascia on that foot.
- Additionally, the foot of the shorter leg falls to the ground harder, putting more force and pressure on that foot.
- Poor flexibility in the calf muscle
- Poor training for physical activities
- Standing too long
- Wearing shoes that don't bend easily under the ball of the foot
- Wearing shoes without enough cushioning on hard surfaces
It's not always possible to identify the cause. Plantar fasciitis tends to develop as we get older and the fascia become less elastic. Women tend to get this condition more than men.