What Is Plantar Fasciitis? How to Identify and Prevent Heel Pain

If you're experiencing tenderness in your heels when you get up in the morning, you may be one of the approximately 2 million people who are treated for plantar fasciitis each year. But what is plantar fasciitis, exactly, and how does it cause you pain?

Causes and Risk Factors

The source of this common condition is the inflammation of a thick band of connective tissue called the plantar fascia; it runs along the bottom of your foot, between your heel bone and toes. This tissue is responsible for providing arch support and stability while walking or running, and when damaged, it can cause debilitating discomfort.

Though experts aren't entirely sure why this condition occurs, some suggest that it is the equivalent of "tennis elbow," an injury caused by repetitive stress or mild damage where the tissue connects to a bone or joint. Factors that may increase the risk of developing plantar fasciitis include:

• Obesity, gout, and chronic joint diseases.
• Age-related deterioration of the heel pad, also known as the plantar fat pad.
• A decrease in flexibility when pointing toes upward from the ball of the foot.
• Having abnormally low arches (flat feet), high arches, or tight Achilles tendons.
• Constant running or standing on hard surfaces.
• Wearing unsupportive or thin footwear.

Preventive Measures

Fortunately, there are a few simple ways to prevent the onset of plantar fasciitis. By avoiding high-impact activities, especially on hard surfaces, you'll limit the constant damage and strain that often lead to plantar fascia inflammation. Wearing supportive shoes that suit your feet will also reduce any potential pain or discomfort.

Next, there's stretching -- the most common, effective, simple, safe, and inexpensive form of preventive treatment. Simply stretching your feet and ankles helps prevent the tightening that leads to heel pain. Here are some stretches that your doctor may recommend:

• Place both hands on a wall and lean forward. One leg should have a bent knee, while the other should be stretched out behind you, with both feet flat on the ground. Hold for about 20 seconds, then switch. This stretches the tendons in the extended leg and ankle.
• Use a 15-ounce can of soup to stretch out your heel. Place the can on its side on the floor, rest your foot on it, and press down with your heel. Hold for 20 seconds, then switch.
• Use a towel for a similar stretch. Sit on a flat surface and extend your leg out straight. Hook the towel around the upper half of your foot, holding each end in your hands. Pull back gently to stretch the tendon along the bottom of your foot. Hold for 20 seconds, then switch.

If you're low on space, such as during the workday, simply take off your shoes and roll the bottom of each foot around on a golf ball. This massaging motion can help prevent and reduce pain.

Other Treatments

If a consistent stretching program fails, there are other treatments available. Your doctor should begin with the least invasive, reserving surgery for a last resort:

• Nonsteroidal anti-inflammatory medications (NSAIDs), also known as ibuprofen and naproxen.
• Orthotic devices, such as shoe inserts and night splints.
• Extracorporeal shock wave therapy, which sends small shock waves through the affected area to help stimulate healing.
• Platelet-rich plasma injections, in which a patient's own blood is put into a centrifuge, removing the plasma cells so that an increased concentration of them can be injected into the affected area to stimulate healing.
• Steroid injections, which can be effective for a short time but do risk damage to the heel pad over the long term.
• Surgery, usually offered if plantar fasciitis persists for a year after diagnosis.

It's good to stretch, yes, but always first check with your doctor regarding which treatment plan is best for you. Nobody should be asking themselves "What is plantar fasciitis?" and prescribing their own treatment plan. It takes consultation with a professional to be certain about the diagnosis, as other conditions can present with the same symptoms. With your doctor's support and the right preventive methods that work for your lifestyle, you can go a long way toward avoiding this type of foot pain.