This article was written by Kevin Moncion MSc PT/PhD Candidate McMaster University working under the supervision of Paulette Gardiner Millar.
Did you know that plantar fasciitis is one one of the most common causes of heel pain?¹
At least 1-million people are affected by plantar fasciitis and it is estimated that up to 10% of people worldwide will be affected by this foot condition at least once in their lifetime.²
Understanding the foot as a whole will help you understand plantar fasciitis
The foot is a complex assembly, composed of 26 bones, 30 joints and more than 100 muscles, tendons and ligaments. Healthy balanced feet will help you stay mobile and stable throughout everyday activities. This “balancing act” starts with the plantar fascia.
What is the plantar fascia?
The plantar fascia is the longest band of thick fibrous tissue in the foot. It runs from your heel to the base of your toes. It helps form the longitudinal and medial arch of your foot.³
The plantar fascia together with the small intrinsic muscles of the foot play an important role in sensation and motor control of your feet.⁴ This sensation and motor control is important for coordinated activities, such as walking and running.
Are you at risk for plantar fasciitis?
If you’re someone who is actively on their feet all day, or someone who is spending a lot of time at your desk, it’s understandable why you may suffer from plantar fasciitis. In fact, individuals who are highly active are at greatest risk for plantar fasciitis, but sedentary individuals are also at high risk.³ Some common risk factors for plantar fasciitis include: a highly active running regime, prolonged standing or sitting, decreased ankle range of motion, calf tightness, flat-footed or high-arched feet, and obesity.²³⁵
What causes plantar fasciitis?
Upon sudden weight bearing, most of the load falls between your big toe to your heel, also known as the medial edge of your plantar fascia.³
As your plantar fascia helps to form the arch of your foot, any excessive load or chronic overload on the arch stretches the plantar fascia.⁵ This can lead to injuries occurring at the attachment site of the plantar fascia.
Why do I have pain?
The pain is often gradual and most noticeable when taking the first few steps after a long period of inactivity. Most people report pain first thing in the morning or after a long period of sitting at a desk.³ There might be temporary pain relief after a short period of activity (e.g. walking), but the pain quickly returns after prolonged weight-bearing activities.³
If you suffer from plantar fasciitis, you are probably wondering: what can I do to help ease this pain?
First things first, you should see a physiotherapist if you haven’t already! A physiotherapist can determine the cause of injury and an appropriate course of rehabilitation. They will help you get back on your feet! A large majority (90-95%) of people experience symptom resolution within a year.³
However, there are also a couple of things that you can try at home to relieve the pain in your feet.
What can you do at home?
The first course of action should be modify the activities that cause your plantar fasciitis pain. Activities that involve repetitive impacts (e.g. running) should be avoided initially.
Seek other activities that are non-weight bearing, like cycling. If you are experiencing no pain or tenderness on the plantar fascia for 4-6 weeks, then speak with your physiotherapist to see if you can return to normal activities.³
Plantar fascia and calf stretches
In many instances, pain and symptoms from plantar fasciitis can be alleviated by simply stretching the fascia and your calf muscles before going to sleep, before getting out of bed, and/or getting up after prolonged sitting at your desk.
- Calf and plantar fascia stretch using a towel
Pull back on foot for 30 seconds, rest for 30 seconds. Repeat 3 times.
- Plantar fascia stretch with massage
Pull back on your toes, stretch and massage the plantar fascia as tolerated for 1 minute, then rest for 30 seconds. Repeat 3 times.
- Roll plantar fascia with can, ball or frozen bottle
While standing or sitting, roll plantar fascia as tolerated for one minute, then rest for 30 seconds. Repeat 3 times.
Proper footwear or custom made orthotics may also play a role in treating and preventing plantar fasciitis by reducing motion (e.g. excessive pronation) that will relieve pressure on the fascia.⁶ Speak to your physiotherapist to examine whether footwear modifications are an ideal treatment for you.
Plantar fasciitis is a common problem for many people. Luckily, recovery is generally effective and well-tolerated if a variety of treatment modalities are used in combination with your home exercises.⁶
If you’re experiencing pain in your feet and think you might have plantar fasciitis, it’s best to book an appointment with a qualified physiotherapist to get a full assessment and treatment plan in place.
- Riddle DL, Schappert SM. Volume of Ambulatory Care Visits and Patterns of Care for Patients Diagnosed with Plantar Fasciitis: A National Study of Medical Doctors. Foot & Ankle International. 2004;25(5):303-310.
- Riddle DL, Pulisic M, Pidcoe P, Johnson RE. Risk factors for Plantar fasciitis: a matched case-control study. J Bone Joint Surg Am. 2003;85(5):872-877.
- Lim A, How C, Tan B. Management of plantar fasciitis in the outpatient setting. Singapore Medical Journal. 2016;57(04):168-171.
- Mckeon PO, Fourchet F. Freeing the Foot. Clinics in Sports Medicine. 2015;34(2):347-361.
- Schwartz E. Plantar Fasciitis: A Concise Review. The Permanente Journal. 2014:e105-e107.
- Orchard J. Plantar fasciitis. BMJ. 2012;345(oct10 1):e6603-e6603.