Plantar fasciitis is the most common cause of pain at the bottom of the heel and is responsible for up to 15% of all foot pain symptoms in adults. It is more common in active runners, people in the military and it peaks in people 40-60 years of age.
In addition to these, contributing factors leading to the development of this condition are:
- Jobs that require prolonged standing
- Heel Spurs
- Excessive running (wearing inadequate shoes)
- Medical conditions such as shortening of the Achilles tendon, flat foot, high arched foot etc.
Before I start talking about Plantar fasciitis diagnosis I want to point out that you should never try to diagnose yourself, regardless of the condition you might think you have. Years of training and experience in the field cannot be replaced by an article you read online.
That being said, this condition is often characterized by pain at the base of the heel, which often intensifies after long periods of inactivity (such as sleeping or resting). The pain can also intensify towards the end of the day, especially if you`ve been involved in any strenuous activity – prolonged standing or running for example.
During physical examination, the doctor can also notice tenderness in the painful area or localized redness and swelling. X-ray and magnetic resonance are not commonly used to diagnose PF but they can be used to rule out other possible suspects, such as a fracture.
What Commonly Causes Plantar Fasciitis?
We already mentioned some common causes and risk groups for the development of this condition, but now we are going to go into more details and list some of the most common causes currently being linked, in one way or another, to PF. Those are:
According to the study done by American Orthopaedic Foot & Ankle Society, there is a direct link between weight gain (obesity) and increased risk of developing Plantar fasciitis.
Obesity and foot pain are the two main ingredients for the vicious circle, and once you get in it you might never get out. What happens is people gain weight and put additional pressure to their musculoskeletal system (bones, muscles, ligaments, tendons and joints) and certain sections of that system may give in, in our case the foot.
So they start feeling pain in the foot more often. Maybe they notice the increase in weight and want to do something about. They go out for a run/a walk and increased physical activity just intensifies the pain they are already experiencing. Eventually they just give up since they start to link physical activity to increased sensation of pain.
Plantar Fasciitis Caused By Running Or Walking
In the previous paragraph we linked increased weight gain and PF but that doesn’t mean people in good physical shape are immune to it. Quite the opposite, especially if they run a lot, they are in a risk of developing this condition.
What happens is, plantar fascia (connective tissue which supports the arch of your foot) becomes inflamed and irritated due to the constant strain and stress it is exposed to. Once it gets irritated you can do a number of things:
- Cease physical activity
- Rest or
- Apply ice
But when you do this, you are just addressing the symptoms of the condition, not the cause. The cause may be inadequate running shoes or the surface you are running on, lack of proper stretching, poor running mechanics etc.
So, am I saying running is dangerous and you should stop it and never try it again for the rest of your life? Or course not, I`m just saying it wouldn’t be a bad idea to get someone to help you out with the basic mechanics and running equipment.
Medial tibial stress syndrome, commonly called shin splints, is a condition where pain occurs along the shin bone. The pain is usually caused by microtears in the muscle attachments in the muscles that are attached to the tibia (shin bone). And the most common cause of this microtears is challenging physical activity.
So what is the connection between shin splints and plantar fasciitis? The connection is mostly based on two muscles – tibialis posterior and anterior which support the arch of the foot. They reduce the tension to the plantar fascia while walking (or running) and, in a sense, protect it from harm. But the development of shin splints can damage these muscles and, indirectly increase the chance of developing plantar fasciitis.
Swelling of the feet due to the water accumulation between the tissue cells is called edema. And even though it doesn’t sound serious at all (our body is mostly made of water anyways, right?) it can cause some serious, long-term consequences.
It will, not only cause repetitive swelling of the foot, but also lead to swelling in other parts of the body. Edema is usually caused by:
- Heart, kidney or liver problems
- Poor diet
Even though this is a serious condition and should be dealt with as soon as possible, I struggled to find any conclusive evidence (case studies) linking edema to plantar fasciitis. All I managed to find was a study done by Weil Foot & Ankle Institute where they determined that bone marrow edema was a common MRI finding in chronic heel pain patients. But the link between the appearance of edema and heel pain symptoms remains unclear.
I`m sure everyone is well aware of the power our mind has over our body, but I still see that people struggle to understand just how can psychological changes have physical manifestations. But it is quite simple really – for example, when we are feeling sad or low on self-esteem our muscles tend to contract, we slouch forward and star breathing shallow. In other words, our emotional state manifests itself in a physical manner.
That being said, I still haven’t found a research paper indicating emotional causes may lead to the development of plantar fasciitis, there are plenty of evidence for vice versa – heel pain (as a result of plantar fasciitis) causing psychological stress and disorder.
At the beginning of the article, when I talked about the vicious obese-exercise circle, I said that the person might link physical activity to pain. As soon as this happens, that person will start to pay less attention to their physical appearance, and I`m not just talking about the beauty and trimmed figure, but about the condition their body is in.
It may appear that they start to care less, but deep down inside they are really unhappy about the state their body is in, and this condition can affect the mind and even lead to depression.
It may seem like we did a giant leap there, going from heel pain to depression, but this is just an illustration of how our body works –we are comprised or millions of pieces and individual systems; but they all interconnected and work together, so one tiny problem can have a larger impact than you might think.
Can Flip-Flops Cause Plantar Fasciitis?
This is quite an interesting topic (at least for me) since flip-flops are becoming increasingly popular and if, I may say, I enjoy wearing them during the summer.
We all know that footwear can have a huge influence on the posture of our entire body, not to mention legs and feet. But today I am not going to talk about high heels (don’t worry ladies), our topic today are flip-flops.
Due to their “minimalistic” design, they provide very little, if any, support to the arch of our foot. This information may not be of much significance if you only use flip-flops for short duration (go to the store for example), but if you are using them during any sort of demanding physical activity, on a regular basis, over longer periods of time, they might cause problems with Achilles tendon and plantar fasciitis.
That being said, I`m not sure if anyone uses them for demanding physical activity (I can`t imagine why would anyone use them when running, though I`ve seen some people on few occasions) so I don’t think there is a reason to worry. Also, if your job requires a lot of standing, avoid wearing them just to stay on a safe side, use opened toe sandals with proper foot support instead.
Restless Leg Syndrome
Restless leg syndrome and plantar fasciitis can occur at the same time but there are not necessarily connected. Restless leg syndrome is a neurological disorder and can range from “tickling that won`t stop” to actual physical pain in the muscles.
As we already seen, PF is not a neurological disorder it is a physical problem in the tissue of the foot. So, even though they can affect a person at the same time, they are not causing one another.
Up until now we talked about the causes of plantar fasciitis but now we are going to shift our focus to potential problems this condition can lead to.
Back Pain – We can look at our feet as our foundation (when standing upright) and the way we walk has a profound influence on our posture and entire body. Naturally, people with back pain can try to change the way the walk (they can start limping limp) in an effort to put less pressure to the affected leg.
In this effort, the entire posture can be altered, muscles being forced to take on more “work” than they should, resulting in back pain.
Same goes for: