A ligament connecting the toes to the heel bone, the plantar fascia, is a thick and fibrous flat band located on the sole, which supports the arch of the foot.
It becomes familiar to most people after they have developed plantar fasciitis: pain on the underside of the foot.
The origination and insertion of the plantar fascia
Originating at the medial tubercle of the calcaneus (heel bone), the plantar fascia inserts into the transverse ligaments of the metatarsals: the five long bones that run from the toe bones under the arch of the foot.
The action and basic functional movement of the plantar fascia
The plantar fascia is designed to lower, elongate and stabilise the arch of the foot and absorb shocks, in particular during movement such as walking, running or dancing, but also while standing. It also allows the first metatarsal (the bone behind the big toe) to flex and carry the weight of the body.
What is plantar fasciitis?
Plantar fasciitis is pain under the foot, often at the heel. Recent opinion is that it’s caused by a small tear in the ligament, rather than inflammation.
Plantar fasciitis is more common in people over 40 but that doesn’t mean it can’t affect younger people too.
What causes plantar fasciitis?
There is a lot of dispute about what causes plantar fasciitis. It is fairly common among runners, athletes and dancers, but also can affect inactive people. Some causes are thought to be:
- Wearing flip flops, high heels or badly fitting shoes
- Running regularly, particularly in running shoes with the wrong support
- Spending a lot of time on your feet (it has been referred to as Policeman’s Heel)
- Increased activity after being sedentary
- Major weight gain
However, the shape of your foot and the way you move can also be relevant, for example if you have flat feet or high arches and/or if you have excessive pronation (feet rolling inward) when you walk or run.
It could also simply be a cause of the foot being required to flex and bear weight during the day, then trying to heal in a relaxed position at night.
Finally, it could relate to other muscles, such as developing tight calf muscles from being seated most of the day.
What treatment is there for plantar fasciitis?
Again, there are many different schools of thought on the best way to ease or treat the condition. These include:
- Stretching and strengthening exercises for the foot, calves and Achilles tendon
- Ensuring footwear is supportive
- Changing exercise routines
- Applying an ice pack
- Wearing orthotics (shoe inserts)
- Having cortisone injections
Research has been carried out on night splints, and some have been found to be effective, such as the Strassburg Sock, which pulls the toes upwards, stretching the plantar fascia during the night.
However, some believe that it’s more effective to look holistically at how your body moves and puts strain through your feet, which means taking care of, stretching and exercising muscles in the calves, hips, back and other parts of the body (see our blogs on Lower Back Pain, The Iliotibial Band and SMR Stretching).
Plantar fasciitis can be very painful and limit your ability to walk, run and carry out everyday activities.
If you think you might have plantar fasciitis, you should make an appointment to discuss this with your doctor, to rule out other options such as a bone fracture and decide on a treatment plan.