Plantar fasciitis is a real pain in the foot

Plantar fasciitis is common among athletes and in people who suddenly change their levels of physical activity. PHOTO: PIXABAY

NEW YORK – The pain starts when you wake up – a stab in your heel when you get out of bed, an ache when you put weight on your foot.

The condition is persistent and common. According to the Centres for Disease Control and Prevention, at least 10 per cent of people get it.

Plantar fasciitis, an inflammation of the tight band of tissue on the bottom of your foot, can happen to anyone, said Dr Eveline Tan, a podiatrist at Northwestern Medicine, but it occurs more frequently in people who are on their feet for long periods of time.

“It’s probably more common than most people think,” she said, noting that she has seen a resurgence of patients with the condition as more people have been returning to post-lockdown life.

American golfer Tiger Woods posted on Twitter last November that he withdrew from a golf tournament because he had developed plantar fasciitis in his right foot, making it difficult to walk.

The condition can be agonising, but it is generally temporary, and there are treatments and preventive steps people can take to ward it off. Here is what you need to know.

What causes plantar fasciitis?

The telltale sign of plantar fasciitis is pain in the bottom of the heel, said Dr Nirav Pandya, a sports medicine specialist at the University of California, San Francisco.

That pain becomes pronounced after lengthy periods of inactivity. People with the condition feel their feet throb when they step out of bed after a night’s sleep or when they get out of the car after a long drive, Dr Tan said.

Doctors are not sure about the precise mechanisms that cause plantar fasciitis, said Dr David Walton, an assistant professor of orthopaedic surgery at the University of Michigan. But the condition is common among athletes and in people who suddenly change their levels of physical activity, such as those who get back into working out after an injury or people levelling up the distance as they train for a marathon.

It is also common in people who sit at a desk for long periods of time, he said. Even a small change in the amount of strain you put on your foot can lead to plantar fasciitis.

“A common scenario is that you go to your in-laws’ house, you don’t have slippers and they have hard wood floors that you’re walking on for four to five days straight,” Dr Walton said.

Is there any way to prevent plantar fasciitis?

“No one is safe from plantar fasciitis,” said Dr Amiethab Aiyer, an associate professor of orthopaedic surgery at Johns Hopkins Medicine. And if you have had plantar fasciitis before, you are more likely to develop the condition again, he said.

But there are ways to reduce your risk.

If you are increasing your level of exercise, build up gradually and incorporate rest and stretching into your routine, especially stretching your hamstrings, calves and feet, Dr Walton said.

Even stretching your calf over a stair at work or at home can add flexibility, Dr Pandya said.

Be sure to wear supportive, sturdy shoes. And if you walk a lot throughout the day, try to not wear the same pair of shoes two days in a row, Dr Tan said. If you have to wear a certain kind of shoe for work or school, change it up each day by adding a different insole to cushion your foot and avoid repeatedly straining it in the same way, she suggested.

You will want to dedicate your workout shoes to only exercise and replace them before they get rundown. For runners, that means getting a new pair after six months or about 480km of running, Dr Pandya said.

How do you treat plantar fasciitis?

Home remedies can be helpful for treating the condition early on, Dr Walton said.

Some people turn to soft gel cups that they wear in the heel of their shoes, he said, which are available at some pharmacies. Others put a water bottle in the freezer, then roll it across their feet to relieve pain.

Avoiding walking barefoot on hard surfaces can also help – opt for a pair of slippers or “house shoes” instead.

Stretching is the “mainstay” treatment, though, he said.

In more severe cases, in which symptoms linger and the foot continues to bear repetitive stress, plantar fasciitis can become chronic and the band of tissue at the bottom of your foot can degenerate. A doctor may recommend physical therapy or place the patient in a boot or cast, Dr Tan said.

Very rarely, doctors may also prescribe a steroid injection.

These more complicated cases can take months or even years to heal, but people who spot their symptoms early can recover in a matter of weeks.

It is important to listen to your body, doctors said, and to seek a podiatrist or orthopaedic foot and ankle surgeon if your pain persists for weeks.

“You shouldn’t wake up in the morning thinking, ‘My feet are killing me,’” Dr Tan said. NYTIMES

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