In this guide we will be looking at plantar fasciitis and understanding the root causes of this very painful injury. By better understanding the causes of plantar fasciitis you will better understand how to treat and prevent it!
Heel pain has an effect on more than 50% of individuals, and most commonly caused by plantar fasciitis. Anyone can get plantar fasciitis and it is brought on by the inflammation of a thick band of tissue, called the plantar fascia, which is found at the bottom of your foot, and attaches the heel bone to the toes. This strong fibrous band of tissue, along with the muscle and bones, forms the arch of the foot and helps to support your feet and shift weight whilst you walk. If you strain your plantar fascia, it will become weak, swollen, and inflamed. This may cause pain and localised inflammation around your arch and heel.
Plantar fasciitis pain generally impacts the bottom of the heel or arch. Most people will describe the pain as a sharp stabbing, dull ache, or a burning sensation.
The pain is normally most severe whilst taking your first steps of the day after getting up in the morning, or standing up after lengthy period of rest where no weight is placed on your foot. The reason for this is because the fascia will tighten within the night or during periods of resting the feet making the plantar fascia more sensitive to stretching and weight bearing.
Following sustained activity, pain may flare up again because of increased stretching of the plantar fascia. Generally, when someone has plantar fasciitis only one heel of there heels is be affected, however it is not uncommon for both heels to be affected. If you are suffering from foot pain at night, you might have a different foot problem, such as arthritis, or a nerve problem such as tarsal tunnel syndrome.
Plantar fasciitis is most frequently caused by repetitive strain injury to the arches of your feet which can cause micro tears to form weakening and inflaming the plantar fascia. There are a number of factors that can causes increase risk of damaging and inflaming the plantar fascia and developing plantar fasciitis, for example:
The most common cause of damage to the plantar fascia is through over pronation when walking. The foot and ankle requires your foot to pronate during the gait cycle to make the muscles of the hips and legs work function properly and efficiently. Pronation arises as your bodyweight is shifted from the heel to the forefoot when walking or running and causes the foot to naturally roll inwards. Over pronation however is when the foot lands on outside of heel, then rolls inward (pronates) too much, shifting your bodyweight to inner edge instead of ball of the foot. Over pronation can contribute to excessive stress or inflammation on the plantar fascia, which can cause acute discomfort and lead to plantar fasciitis as well as other foot problems.
Supination (Also called under pronation) like pronation, supination is a natural part of all walking and running. During a normal stride, your rear-foot needs to roll inward slightly once your heel hits the ground, helping to absorb shock as well as, helping your foot and leg adapt to uneven surfaces. Over-supination is when the arch of the foot become too high and an excessive amount of weight is put on the edges of the foot. Over supination (also known as hyper-supination) is a lot less common than over pronation and can trigger a wide range of different foot problems for runners and other athletes, because the alignment of the foot is less able to provide you with shock absorption. This can mean those who supinate are at greater risk of damaging the plantar fascia and developing plantar fasciiitis. Over pronation can also affect your body’s overall alignment . Heel bone, leg, thigh-bone and hip rotate outwards, causing your pelvis to tilt, which can cause back pain and problems.
If you have foot problems, such as very high arches or very flat feet, you may develop plantar fasciitis. The shape of your foot can easily change the way your weight is spread across your feet when you are walking or even just standing. If the weight distribution of your feet is a bit off, this may increase your chances of developing of plantar fasciitis. Irregular foot shapes can also cause over pronation and excessive supination as well.
If you happen to examine an adult foot from the inside, you should see an upward curve in the middle. This is called the arch of the foot. If you have flat feet then it means that this arch is totally flat, making it possible for the entire soles of your feet to touch the floor whilst standing up. Flat feet are often are not something that should be a worry, as it estimated 20–30% of the general population and very few people have foot problems because of their flat feet. However some people with flat feet can have associated problems biomechanical problems such as over pronation that can cause excessive strain onto the arches of your feet and cause plantar fasciitis.
The main causes of developing flat feet are:
- Obesity, pregnancy or repetitive impact on a hard surface which can weaken the arch, causing flat feet to develop.
- Injury or inflammation of the posterior tibial tendon, that attaches from your lower leg, down your ankle, to the middle section of the arch.
- Weakened muscles due to ageing or heavy strain placed on the feet.
- Wearing shoes that don’t provide proper arch support may be a contributing factor as well.
Cavus foot (High arches)
Cavus foot is when the foot has a arch that is too high. High foot arches are typically far less common than flat feet. High arches are often brought on by a bone or nerve condition. A high-arched foot will usually lack the required flexibility for proper shock absorption and will tend to roll supinate, increasing the risk of developing plantar fasciitis and other foot problems such as ankle sprains. You can find out if you have high arches feet by examining the footprint your feet leaves behind on wet sand. A high-arched foot should leave a very thin foot print because the arch area will not have touched the ground.
Other causes are:
Tight Achilles tendon
The Achilles tendon is connected to the plantar fascia. If your calf muscles that connect to the Achilles tendon are tight, the ankle will be less flexible, and the plantar fascia also tightens, increasing your risk of over stretching the tendon.
Obesity. Being overweight or obese can place you at a higher risk of developing plantar fasciitis, this is because of the excessive pressure placed on your arches that your plantar fascia is not designed to cope with.
Being on your feet for too long. If you happen to be on your feet for long periods of time, or if you do lots of walking, running, especially if you are not used to it or if you had a much more sedentary lifestyle beforehand.
Poorly fitted shoes. Wearing ill fitted shoes that have soft soles and poor arch support may also cause plantar fasciitis. You should throw away any shoes (or wear less frequently) which have thin soles or poor arch support, or shoes which do not fit your feet properly. Consistently wearing high heels may also cause your Achilles tendon to shorten over time, causing inflexibility in your foot which can bring about biomechanical imbalances.
Ageing. Your plantar fascia have to endure a lot of wear and tear over your lifetime and as a result the plantar fascia can weaken as you get older, that is why plantar fasciits is more prevent in people between the ages of 40 to 70 years old.
If you have plantar fasciitis then you may also develop what is known as a heel spur. A heel spur is a calcium growth on the underside of the heel bone.
The purpose for the heel spurs is that is your body’s response to the continual stretching and pulling of the plantar fascia ligament away from the heel bone. Due to the fact that the plantar fascia itself cannot get any longer the bone will try to ‘aid’ the ligament and grow in order to protect the heel bone. Even though heel spurs more or less painless in most cases, they can cause heel pain in those with plantar fasciitis.
Ignoring plantar fasciitis can sometimes result in chronic heel pain which may prevent you from walking. In some circumstances people may change the way that they walk to help minimize the pain caused by plantar fasciitis, however this can lead to other foot, knee, hip or back problems and worsen the plantar fasciitis in the long run.
Making your sure that your calf muscles are stretched out and limber can help to reduce the strain on the plantar fascia. Stretching your calves and Achilles tendon could’nt be easier. Simply, stand on the edge of a step, placing your bodyweight on the balls of your feet, then slightly bend your knees for around 20-30 seconds once you have done this you should straighten your leg and then repeat the stretch 5-8 more times on each leg. You should do this stretch through out the day for the best effect.
Wear Supportive Footwear.
Although they are extremely ugly to say the least and most people would not be caught dead in public wearing them putting on orthopaedic shoes or orthotic inserts is an simple, excellent way to naturally re position the foot and correct biomechanical problems in the foot causing the plantar fasciitis. A groundbreaking study shows wearing orthopaedic shoes can in 9 out of 10 cases successfully reduce heel pain if the shoes are worn continually during.
If Orthopaedic shoes are not your cup of team the wearing pair of orthotic arch support insoles is also another great way at treating of plantar fasciitis. Unlike orthopaedic shoes you don’t have to compromise your style and can wear them inside just about any type of shoe!
Orthotics are commonly used to help relieve the tension and resultant inflammation associated with plantar fasciitis.
Best insoles to buy for plantar fasciitis
Orthotic insoles help to realign and the feet and prevent your feet from over pronating or supinating by correcting the function of your feet.
Heel cups are common orthotics inserts used for treating plantar fasciitis. Heel cups function in a number of different ways to help reduce strain on the plantar fascia and get you back on your feet. First of all, heel cups help to lift the foot just a little that helps minimize the strain on the Achilles tendon that subsequently helps to decrease the strain on the plantar fascia as well. Heel cups also help to better cushion the feet by spread pressure from underneath the heel and absorb damaging shock, which again helps to lessen the the strain on plantar fascia, especially if you also suffer from a heel spur.
Heel cups are the most basic and compact form of orthotics for plantar fasciitis that you can buy. They are often very light weight and can be fitted into just about any type of shoe. Gel heel cups, are often very flexible and are more comfortable to wear than the more rigid types of insoles for plantar fasciitis.
Full legnth arch support insoles
In some cases, some individuals may require more support than just at the heel and may want to buy a pair of full length insoles for plantar fasciitis instead. Full length insoles are designed to help correct foot biomechanical issues that may be causing Plantar fasciitis by supporting the foot in a more natural way. Full length insoles usually provide you with extra padding and support throughout the entire sole of the foot.
If wearing orthopaedic shoes or even insoles aren’t your thing then Night splints could be! Night splints help to pull the foot and toes back whilst you are sleeping so that a light stretch is retained on the calf muscles, Achilles tendon and plantar fascia during the night. Generally, we sleep with our feet aiming downwards making the arch of our foot more susceptible to tightening, however night splints are a great way combating that and help you reduce aches and pains in the morning associated with plantar fasciitis and allow the plantar fascia to heal properly.