Plantar fasciitis is the leading cause of heel pain in adults. It is estimated that 10% of the population will experience the condition in their lifetimes. Who is at risk, and how is it treated? UC Davis Health family and community medicine and sports medicine physician Marcia Faustin breaks down the painful problem.
“This is one of the most common foot complaints we see,” Faustin said. “And it affects women more than men.”
The disorder is caused by strain in the plantar fascia, the thick, web-like tissue beneath the skin and at the bottom of the foot that extends from the heel to the toes. Patients with plantar fasciitis experience pain in their heel or arch. Frequently, the first step out of bed in the morning is the most painful.
“Think of a rubber band from your heel to toes,” Faustin said. “If the band is loose while you’re sleeping, your first step pulls on the rubber band, causing significant pain.”
It’s not just athletes (typically runners) who are predisposed to plantar fasciitis. People whose jobs require standing on hard surfaces – teachers, nurses, mail carriers – are also at risk for the condition. Additional risk factors include obesity, sedentary lifestyles, high or low arches, and inflexibility of the Achilles tendon or calf muscles.
Dr. Faustin cautions those who want to begin an exercise routine or get back into the habit to be patient, remember to stretch and go slow to avoid problems like plantar fasciitis.
But, there’s good news. Patients who manage their plantar fasciitis symptoms usually get better within a year.
“A year is a long time, but there’s a lot you can do to help yourself,” Faustin said. “I encourage patients to work on stretching their lower legs, focusing on the calf muscles and get shoes with good arch support.”
For anyone with plantar fasciitis who would still like to stay physically active, Faustin suggests cross-training such as swimming or biking to alleviate foot pain. Runners can use a specific tape technique to take pressure off of the fascia and should get new shoes regularly to maintain appropriate cushioning.
After the gym or a long day at work, Faustin recommends “RICE”: rest, ice, compression and elevation, along with stretching and considering a night splint.
“Try freezing a 16-ounce water bottle and rolling your foot over it to help relieve pain,” she said.
While plantar fasciitis is prevalent, Faustin urges patients to ensure they actually have it. Nerve injuries such as tarsal tunnel syndrome, stress fractures or even autoimmune disorders can cause similar foot pain.
“First and foremost, get the correct diagnosis,” Faustin said. “Patients are frequently referred to our sports medicine clinic if the diagnosis is not clear or the initial treatment failed. My colleagues and I are able to help confirm the diagnosis and provide more treatment options. This gives patients the opportunity to work with a specialist on a specific issue and gives us time to form the right diagnosis.”
If symptoms persist or worsen, there are additional options to help with quality of life. Physical therapy is especially important for patients who are prone to plantar fasciitis. Other options include steroid or platelet-rich plasma injections, shock wave therapy or surgery to alleviate the pain.
The interdisciplinary sports medicine team at UC Davis Health includes specialists in orthopaedic surgery, foot and ankle disorders, physical medicine and rehabilitation, and even biomedical engineering to fully support each patient’s needs.
“One person can’t do it alone,” Faustin said. “Collaboration with specialists is a strength of the health system. That’s why I’m so positive about our sports medicine clinic.”