Plantar Fasciitis

If you have heel pain when you first stand up in the morning, it may be plantar fasciitis.

Plantar fasciitis is an overuse injury that causes inflammation of the tough, fibrous band of tissue (fascia) connecting your heel bone to the base of your toes.

Plantar fasciitis tends to start with mild pain at the heel bone. The pain typically occurs first thing in the morning and after exercise and resting, but usually not while you're working out. Some people with the condition report that walking relieves the pain, but it returns after they spend long amounts of time on their feet.

In adults, plantar fasciitis is the most common cause of heel pain. It is estimated that this condition occurs in more than two million Americans every year.

Plantar fasciitis may limit your ability to exercise and participate in normal daily activities. People with the condition often limp, place their body weight on the toes or try to avoid walking on the affected foot. Plantar fasciitis may prevent you from bending the foot, causing the toes to point upward toward the shins, which may be painful.

Plantar fasciitis has several causes. Some can be controlled, some can't. Risk factors include the following:

Age

Plantar fasciitis most commonly occurs in adults between the ages of 40 and 60. Getting older causes the fat pad on the heel to thin and be less effective at absorbing the shock of walking or running.

Athletic activity

Plantar fasciitis is among the most common foot and ankle injuries experienced by professional athletes. Running on a regular basis and certain forms of dance (ballet and dance aerobics) may cause this condition to occur at a younger age. Doing too much too soon, such as increasing weight-bearing activity, duration of runs and stress-inducing workouts, may bring about plantar fasciitis. Training on hard or uneven surfaces or with inadequately supportive footwear also may increase the risk for developing this condition.

Body weight

In nonathletes, being overweight, obese or pregnant is a risk factor for plantar fasciitis. People with a body mass index (BMI) over 25 are at the greatest risk for this condition.

Diabetes

In people with diabetes, plantar fasciitis may result from muscle atrophy, anatomical changes in the foot and changes in gait.

Foot abnormalities

Flat-footedness, having too high of a foot arch, heel spurs or a tight Achilles tendon (which connects the calf to the heel) may increase the risk for plantar fasciitis. People who have high or flat arches and a limited range of motion when flexing the foot upward may have the highest risk for the condition.

It was once thought that heel spurs (bone spurs, small calcifications in the foot) caused plantar fasciitis. Research has found that this theory lacks evidence; however, up to one-half of patients diagnosed with plantar fasciitis may have heel spurs.

Spending a lot of time on your feet

Occupations that involve spending a long time on the feet, either walking or standing, may increase the risk for developing plantar fasciitis.