Plantar Fasciitis: what it is and how to relieve discomfort

Published: 3 June, 2024 | 6'

Plantar fasciitis is one of the most common foot conditions and can occur due to various causes, usually related to lifestyle and physical activity. 80% of people who seek professional help for discomfort in the heel area are diagnosed with plantar fasciitis.⁶ Fortunately, it is usually a temporary condition that can improve with appropriate treatment within a few weeks. 

To explain this very common condition, especially among athletes, and how to relieve the symptoms of plantar fasciitis, we turn to Dr. José Luis Castilla, a specialist in physical medicine and rehabilitation.

What is plantar fasciitis and why does it occur?

"The main distinctive characteristic of plantar fasciitis is the varying intensity pain that occurs in the plantar fascia as a result of inflammation," explains the doctor, "the plantar fascia is a band of connective tissue that extends from the bottom of the calcaneus, a bone located at the back of the foot, to the base of the toes." This band is essential for the basic functions of the foot such as walking, running, or propelling, as it supports the arch of the foot and absorbs the impact when performing these activities.

When the fascia is subjected to excessive tension for a prolonged period of time, it can result in excessive and abnormal growth of the bone tissue in the calcaneus, leading to calcification known as a spur.

Causes of plantar fasciitis

Plantar fasciitis can be caused by various factors, either related to lifestyle or intrinsic causes specific to the individual, let's see some of them:

• Flat feet or high arches: Flat feet, high arches, or those with an unusual walking pattern can affect the way weight is distributed while standing, leading to more tension in the plantar fascia and increased risk of discomfort. 
• Overweight or obesity: Excess weight puts more pressure on the plantar fascia.
• Exercises that put pressure on the heel such as running or jumping regularly can contribute to its onset.
• Standing or sitting for long periods of time as part of a regular routine: Professions that require standing or walking on hard surfaces for several hours can be a risk factor for plantar fasciitis. The opposite can also occur in individuals with a sedentary lifestyle.
• Type of footwear: Shoes with very rigid soles, little support such as high heels or sandals in the summer, as well as poor fitting shoes, can affect the development of plantar fasciitis.
• Age: although not a determining factor, plantar fasciitis is more common in people between 40 and 60 years old.

Symptoms of plantar fasciitis

The most common symptom is intense pain in the bottom of the heel and arch, but it can also extend to the sole of the foot or feel burning and inflammation in this area.

When do the symptoms occur?

In some situations, the pain associated with plantar fasciitis can slowly and gradually appear or suddenly occur after intense activity and persist until treated.

Normally, the pain worsens in the following situations:

• In the morning when getting up and taking the first steps.
• When climbing stairs.
• After sitting or standing for a long time.
• After finishing intense physical activity.
• When walking long distances, running or jumping.

Diagnosis of plantar fasciitis

If you identify with the situations mentioned above, it is advisable to seek professional help to determine and confirm that it is plantar fasciitis in order to follow the recommended guidelines for improvement, ruling out other possible causes of greater relevance.

This will usually involve a physical examination of the foot area where the plantar fascia attaches to the calcaneus, taking into account any pre-existing conditions such as flat or high-arched feet that may pose a higher risk of developing plantar fasciitis. By assessing the patient's sensitivity to palpation, the origin of the discomfort can be determined.

"It is also important to determine and identify if there is redness or swelling and also if there is stiffness or tension in the arch of the foot and/or the Achilles tendon to determine if it is plantar fasciitis," continues Dr. Castilla.

On some occasions, an X-ray is required to rule out other problems such as the presence of a spur in the heel. However, the presence of a spur is not decisive for plantar fasciitis and does not necessarily imply complications or confirm this condition.

As the causes of plantar fasciitis are diverse and some depend directly on the individual, it is important to conduct a thorough study of the gait and implement a routine of stretches and exercises that strengthen the muscles involved in the condition and help reduce the intensity of discomfort.

"A gait study plays a fundamental role in both the diagnosis and prevention of plantar fasciitis, as well as other possible lower limb conditions", confirms Dr. Castilla, "as it will help us detect alterations that can trigger this condition or others early on and prevent their occurrence."

Treatments for plantar fasciitis

For proper management of plantar fasciitis, it is ideal to approach it from a multidisciplinary standpoint with medical monitoring and physiotherapy. In some cases, it may also require podiatry attention, depending on its origin.

Symptom improvement usually takes several weeks, and surgical intervention is not necessary. Instead, patients should follow the guidelines provided by healthcare professionals both in the clinic and in their lifestyle. As Dr. Castilla suggests, "in this type of condition, the patient should take an active role and follow the instructions indicated by their doctor or physiotherapist, such as performing stretching exercises, massages, or specific exercises."

Conventional treatment

After a healthcare professional has made the diagnosis, patients will be advised to follow a series of guidelines in their daily life to facilitate recovery, in addition to continuous professional monitoring.

There is no predetermined time for treating plantar fasciitis, as it depends on various factors and, of course, each case should be addressed individually. However, the normal process usually takes several weeks and requires consistent collaboration between the patient and the healthcare professionals.

Recovery: Stretching and Massages for Plantar Fasciitis

The primary focus of a proper recovery for plantar fasciitis is "to reduce discomfort in the foot area through stretching, massages, and lifestyle adjustments", explains the doctor. "If necessary due to the intensity of the pain, oral analgesic medication and anti-inflammatory drugs can be used. In refractory cases to conservative treatment, infiltrations can be attempted."

As a first step, it is important to rest as much as possible and reduce activities that exacerbate the discomfort, especially those that impact the plantar area of the foot, such as jumping or running. Additionally, Dr. Castilla suggests that "there are stretches and massages that patients can perform at home to improve plantar fasciitis" and recommends the following:

• Gentle and regular stretches of the sole of the foot and surrounding muscles, using a wall or towel for support. First, stretch the sole of the foot and apply pressure to the toes, then apply pressure to the dorsiflexion of the foot to feel tension in the back of the leg.
• Roll a frozen water bottle with the foot for about 15 or 20 minutes several times a day, moving it forward and backward. The cold helps reduce discomfort.
• Massage the foot daily from the heel to the toes using a massage oil such as Artohelp Sports Massage Gel, which contains extracts of Arnica and Devil's Claw and is highly beneficial in the recovery of muscles, joints, and ligaments.

In addition, performing strengthening exercises for the muscles of the foot and calf, guided by a professional or physiotherapist, can help stabilize the arch of the foot or correct possible postural alterations and reduce the likelihood of plantar fasciitis recurrence.

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Nutrition and Supplementation

Alongside exercise, stretching, and massages, nutrition plays a key role in the health of the musculoskeletal system. As we age, nutrient production such as Collagen, Hyaluronic Acid, Chondroitin, and Glucosamine naturally decreases in our connective tissues, such as tendons and ligaments.

These compounds can be found in foods such as fish. The diet can be supplemented with dietary supplements that include these ingredients.

Content developed by the Scientific Information Department of MARNYS in collaboration with specialists. This article is informative and does not replace consultation with your healthcare professional.

Healthcare Specialists