Introduction

Plantar fasciitis is a common condition that causes pain in the heel and bottom of the foot. It occurs due to inflammation or degeneration of the plantar fascia, a thick band of tissue that connects the heel bone (calcaneus) to the toes and supports the arch of the foot. It is especially prevalent among athletes, people who stand for long periods, and those with certain foot structures like high arches or flat feet.

Symptoms

The main symptoms of plantar fasciitis include:

• Heel pain, especially when taking the first steps in the morning or after long periods of rest.
• Pain that decreases with activity but may worsen after prolonged standing or exercise.
• Tenderness along the bottom of the foot, particularly near the heel.
• Swelling in some cases, though not always present.
• Stiffness in the arch and heel.

Causes and Risk Factors

Plantar fasciitis is caused by overstretching or overloading the plantar fascia. Common contributing factors include:

• Excessive running or high-impact activities
• Obesity or sudden weight gain
• Flat feet or high arches
• Improper footwear (lack of support or cushioning)
• Occupational stress (standing or walking on hard surfaces for long periods)
• Tight calf muscles or Achilles tendon
• Age – more common in people between 40–60 years old

Treatment

Treatment usually starts with conservative measures. Most people recover within 6–12 months with proper care.

1. Rest and Activity Modification

• Reduce activities that aggravate heel pain, such as running or jumping.
• Avoid walking barefoot on hard surfaces.

2. Footwear and Orthotics

• Wear shoes with good arch support and cushioning.
• Use heel pads or orthotic inserts to reduce strain on the plantar fascia.

3. Medications

• NSAIDs (e.g., ibuprofen) to reduce pain and inflammation.
• Topical anti-inflammatory gels in some cases.

4. Stretching and Strengthening Exercises

Regular exercises help relieve tension in the plantar fascia and surrounding muscles:

a. Plantar fascia stretch

• Sit and cross one leg over the other.
• Pull the toes toward the shin until you feel a stretch along the arch.
• Hold 15–30 seconds, repeat 2–3 times per foot.

b. Calf stretch

• Stand facing a wall, place hands on the wall.
• Step one foot back, keeping it straight, and press heel into the floor.
• Hold 15–30 seconds, repeat 2–3 times per leg.

c. Towel stretch

• Sit with legs extended, loop a towel around the ball of your foot.
• Gently pull toes toward you, stretching the arch.
• Hold 15–30 seconds, repeat 2–3 times per foot.

d. Rolling exercise

• Roll your foot over a frozen water bottle or a tennis ball for 5–10 minutes.
• Helps massage and relax plantar fascia.

e. Toe curls / towel scrunch

• Place a towel on the floor, use your toes to scrunch it toward you.
• Strengthens small foot muscles supporting the arch.

5. Physical Therapy

• Therapists may use ultrasound, massage, or night splints to reduce pain.

6. Advanced Treatments (if conservative therapy fails)

• Corticosteroid injections to reduce inflammation.
• Shockwave therapy for chronic cases.
• Surgery (rare, only in persistent cases) to release plantar fascia tension.

Prevention

• Wear supportive shoes.
• Maintain healthy body weight.
• Stretch calves and plantar fascia regularly.
• Gradually increase exercise intensity.