Megan Johnson McCullough, a fitness nutrition specialist, master trainer, wellness coach and a member of the Men’s Health Magazine Fitness Council, is currently in the doctorate program of Health and Human Performance at Concordia University Chicago. Here she gives SportsMD.com readers a look at plantar fasciitis, defined as an inflammation of a thick band of tissue that connects the heel bone to the toes, as well as some tips to alleviate some of the pain and limit its recurrence.
SportsMD: Can you describe plantar fasciitis and how it occurs?
Megan Johnson McCullough: The plantar fascia acts like the absorbing shock spring in our foot. Repetitive stretching and tearing of this area results in the stabbing pain. Overly stretched, tiny tears can lead to inflammation and pain in the arch of the foot. This condition, called plantar fasciitis, accounts for nearly 1 million doctor visits per year.
Our foot has a thick band of tissue called fascia that runs from our heel to our toe. This troublesome foot issue is actually more common in women than men. We need to spend time on our feet moving, so this foot problem is not conducive to our health.
SMD: Who is likely to get this condition and what are some contributing factors?
MJM: Plantar fasciitis is more common as we age (specifically between ages 40 and 60), but is also more likely to occur if one is overweight or on constantly on their feet. It is very common in runners. Activities that are known for high rates of plantar fasciitis include ballet, dance, long distance running, and ballistic jumping.
Another factor is wearing shoes that are worn out and have thin soles or wearing high-heels. The mechanics of how you walk (your stride) involves your foot position. If you have flat feet or a tight Achilles, the body will compensate for these dysfunctions which can lead to injury of the fascia.
We do use and abuse our feet and they bear quite a bit of weight for all the functions we perform. We have to walk to get from point A to point B and get those 10,000 steps in. The Lifestyle of the FIT & Healthy practices self-care from head to toe to heel. Sometimes compromising a pair of cute shoes is worth the fashion sacrifice.
SMD: How can the patient know he or she may have plantar fasciitis?
MJM: Pain starts to occur near the heel towards the bottom of the foot. Most people feel the pain in the morning right when they get out of bed. This is known as “first-step pain.” This can also occur if you have been sitting for a long period of time and then stand up.
SMD: What are some treatment options?
MJM: A doctor might prescribe anti-inflammatory medication. A steroid injection can be done. Physical therapy and massage can help. Shock wave therapy is used to stimulate blood flow. A tenex procedure can remove scar tissue in the area. Surgery can be done to remove the plantar fascia off the heel bone.
Wearing the right shoes often times does the trick so be sure to try that first. Shoe inserts can be effective. Ice and soaking the heel can help. A good home remedy is freezing a foam cup of water then rubbing the top of the cup on the heel for 10 or so minutes.
Stretching the calves and Achilles tendon can alleviate pain over time. There are also ways to tape the area of the foot to position the heel correctly with each step. Night splints can be worn to hold the foot at a 90 degree angle to stretch the fascia.