What is plantar fasciitis?
Inflammation of the arch tendon is the most common cause of pain under the heel. Heel spurs is a common condition associated with this type of pain. These ‘spurs’ refer to small bony protrusions or bumps that form on the underside of the heel bone which sometimes show up on X-rays in patients suffering from foot and heel pain.
However, medical studies rule out a connection between heel spurs and the pain people typically feel in their heels and feet. The pain is actually the result of a sprained or inflamed arch tendon, and so plantar fasciitis is therefore a more precise name for the condition as it means ‘inflammation of the arch tendon’ in Latin.
The arch tendon is a large tendon under the foot that runs from the heel and stretches all the way to the tip of the toes. It functions like a natural ‘spring’ that helps the body to offset pressure from landing after a jump and thus serves as an important shock absorber.
- Around 10% of the general population will suffer from plantar fasciitis at some point during their lifetime.
- Plantar fasciitis is most prevalent in those aged between 45 and 64.
Plantar fasciitis is Latin and means ‘inflammation of the arch tendon.’
As the arch tendon attaches to the tip of each toe, it is also plays a crucial role in everyday activities such as walking. The arch tendon helps to stabilize the foot by forcing the toes to bend backwards during movement. This, in turn, helps to tighten and hold the curve of the foot in place, thereby ensuring arch stability.
Causes of plantar fasciitis
Inflammation of the arch tendon is typically caused by extra pressure on the foot produced by activities such as running, jumping, unusually long walks or long hours of standing work. A heavy body weight, combined with hard surfaces, will also increase the risk of developing inflammation of the arch tendon. If you suffer from flatfoot or hollow foot, then you are at an increased risk of developing plantar fasciitis.
The most common symptom is pain under the heel when pressure or weight is put on the foot. Typically, the pain will be at its worst when you get out of bed in the morning. As the foot warms up, though, the pain will often diminish to some degree. If the pain is also present during inactivity, then it is common for the pain to be at its worst during the evening after performing activities during the day.
Symptoms of plantar fasciitis
- The most common symptom related to plantar fasciitis is pain under the foot. The pain is often located in the heel under the foot.
- Sometimes the pain will radiate outwards from the heel area towards the toes.
The pain will typically be at its strongest first thing in the morning after getting out of bed or when walking or standing up after a period of inactivity (such as sitting down).
Diagnosis and treatment
To relieve any pain or discomfort in the foot, you should avoid jumping, running and/or similar activities that inflame or tax your arch tendon. You can also try changing your footwear to see if this reduces the amount of pressure on your foot arches.
Doing exercises aimed at stimulating circulation in the damaged tissue is a good way to treat plantar fasciitis. Special focus should be placed on strength training, which has been shown to be effective in preventing further injury. Most people will also benefit from stretching the Achilles tendon and the leg muscle, as well as performing exercises to increase arch stability and mobility in the foot and ankles.
Use the Injurymap screening tool to find out if you are ready to treat your heel and foot pain with rehabilitative exercises.
Health facts and statistics about plantar fasciitis
How many people are affected by plantar fasciitis?
It is estimated that plantar fasciitis is one of the most common causes of chronic heel pain. Between 11% and 15% of all adults who see their physician about foot symptoms are diagnosed with plantar fasciitis. In fact, one in ten people will suffer from plantar fasciitis at some point in their lifetime.
Tenderness in the heel is one of the major symptoms related to this condition, particularly amongst older patients who suffer from plantar fasciitis. Approximately 7% of those who aged over 65 will suffer from this problem, with heel pain typically being the symptom most likely to cause them to seek out a diagnosis.
What activities increase the risk of developing plantar fasciitis?
Inflammation of the plantar fascia and the subsequent cascade of symptoms associated with the condition are most commonly seen in those who engage in regular physical exercise. Athletes, runners, joggers – these are just a few of the categories most at risk.
Trying to maintain an active training regime, such as running or jogging, while ignoring the symptoms of plantar fasciitis can worsen symptoms, leading to more chronic conditions. Often, these types of physical activity will lead to intense muscle contractions, particularly in the plantar flexor muscles.
This can cause the plantar fascia to overstretch and thus, become inflamed, leading to muscle strains. This is because the plantar fascia is being forced to alternate between stretching and contracting over a protracted period.
Over time, this leads to micro-tears in the muscle, making the condition worse. While activities such as running, and jogging should be avoided during recovery, the injured foot still needs to be treated with the correct types of exercises.
What jobs increase the risk of developing plantar fasciitis?
All activities that involved prolonged weight bearing on the foot, such as standing for several hours or more, tend to increase the tensile load on the fascia and lead to plantar fasciitis. Certain job categories such as hairdressing, sports and the military are associated with an increased risk of developing plantar fasciitis, football players or soldiers standing guard being typical examples. Prolonged weight bearing on the foot, whether moving or stationary, is enough to cause the plantar fascia to become tensioned and inflamed.
Dancers, orienteering instructors and anyone whose work requires standing or walking on hard surfaces are also at increased risk of developing these types of problems. Studies have shown that plant assembly workers and truck/forklift drivers are another occupational group who are frequently diagnosed with plantar fasciitis.
Who is more at risk of developing from plantar fasciitis?
Certain groups of people have a higher risk of suffering from plantar fasciitis than others. Statistics reveal that 70% of all those diagnosed with plantar fasciitis are clinically obese (have a body mass index over 30), showing a clear link between high BMI and plantar fasciitis.
In fact, those with a BMI over 30 are five times more likely to suffer from these kinds of mobility issues than those with a lower value.
Demographically, the highest incidence of plantar fasciitis tends to occurs in middle-aged, clinically obese women but is also very common in in young male athletes. Pre-existing conditions, such as spondylarthropathy will also place one at greater risk of developing plantar fasciitis, as will a family history of similar issues.
Age is another risk factor. The prevalence of plantar fasciitis tends to peak between the ages of 45 and 64, but as a general rule, the older you are, the higher your the risk becomes for developing the condition.