By Maureen Mahoney, PA-C, ATC

Do you get stabbing pain in the heel or bottom of your foot with your first steps out of bed in the morning? Does it feel better once you start walking around? Does the pain return after standing for a long time or at the end of the day? Do you get heel or arch pain when you get up from sitting? These are some of the symptoms which could indicate you are suffering from Plantar Fasciitis.

Maureen Mahoney, PA-C, ATC
Maureen Mahoney, PA-C, ATC

Plantar Fasciitis is one of the most common causes of pain affecting the heel and underside of the foot. It involves the inflammation and break down of a thick band of tissue that travels across the bottom of your foot. The band of tissue starts at the base of the toes, crosses the bottom of the foot, and attaches to the heel bone. This tissue acts like a shock-absorbing trampoline, supporting the arch of your foot when you stand. If there is too much tension in this tissue, than it can create small tears which can cause irritation, inflammation, tissue breakdown, and pain. Approximately 10% of people have plantar fasciitis at some point during their lifetime. If you don’t treat plantar fasciitis, it may become a chronic condition. You may not be able to keep up your level of activity or do the things you want to do.

The cause of plantar fasciitis is poorly understood and is thought to likely have several contributing factors. Some risk factors that increase your chances of developing plantar fasciitis include having a job that requires long hours on your feet, especially if standing on hard surfaces. People in occupations such as factory work, nursing, retail work, or teaching are at higher risk of developing pain. Plantar fasciitis is most common in people between the ages of 40 and 60. People with faulty foot mechanics, like having flat feet, having high arches, or having an abnormal pattern of walking can have changes in their mechanics and can put more stress through the bottom of their feet. Achilles tendon tightness, calf tightness, and inappropriate footwear have also been identified as significant risk factors. There are also certain types of exercise that can put a lot of stress through the arch and heel, such as running and aerobics that can also increase your risk. Among non-athletic populations, degeneration, or breakdown, of the plantar fasciitis can be associated with obesity and lack of physical exercise.

Some things you can do to help prevent or reduce the pain of plantar fasciitis include not wearing worn out shoes, wearing supportive shoes, and maintaining a healthy weight. If you have symptoms and are active, try varying your activity and get involved in a lower-impact sport like swimming or bicycling. Regular stretching of the calf and arch can help. Applying ice packs several times a day or after activity can also help relieve your symptoms.

Plantar fasciitis is usually diagnosed by a health care provider and some people may need further evaluation or treatment by a sports medicine professional or physical therapist. Most people who have plantar fasciitis recover with conservative treatment in just a few months.

Maureen Mahoney, PA-C, ATC is a certified physician assistant at BMH Orthopaedics & Sports Medicine, a department of Brattleboro Memorial Hospital. She can be reached at 802-251-8611.