By the Fitness Chiropractic team · Updated
What is plantar fasciitis?
The plantar fascia is a thick band of tissue that runs along the sole of your foot, from the heel bone to the base of the toes. It supports your arch and acts a bit like a spring every time your foot hits the ground.
Plantar fasciitis is pain and irritation where that band attaches to the heel. It's one of the most common causes of heel pain in adults. Repeated strain leads to small areas of damage and thickening in the tissue, and when it doesn't get the chance to recover, the heel becomes sore.
Plantar fasciitis symptoms
The classic sign is a sharp or stabbing pain in the bottom of the heel with your first steps in the morning. It usually eases as you get moving, then comes back after you've been sitting for a while or after long periods on your feet.
Other common signs include:
- Tenderness when you press on the inside of the heel
- Pain that's worse after exercise rather than during it
- Heel pain when standing on hard floors for long shifts
- A tight feeling in the arch and calf
What causes plantar fasciitis?
Plantar fasciitis builds up when the load on your feet outpaces the tissue's ability to recover. Risk factors include:
- Middle age — it's most common between about 40 and 60
- Running, especially long-distance running or a sudden increase in mileage
- Jobs that keep you on your feet, such as teaching, retail, nursing and warehouse work
- Extra body weight or recent weight gain, including during pregnancy
- Foot shape — flat feet and high arches both change how load passes through the fascia
- Tight calves and Achilles tendon, which increase the pull on the fascia
- Unsupportive shoes, worn-out soles and long periods barefoot on hard floors
New patient special
Get your plantar fasciitis checked — $75
Diagnosing heel pain
Your first visit includes a full orthopedic and neurological exam. We ask about your symptoms and daily routine, press around the heel and arch to find the sore spot, and look at your calf flexibility, ankle motion and how your foot moves when you walk.
A physical exam is usually enough to identify plantar fasciitis. Imaging is only needed if something else is suspected, such as a stress fracture. X-rays sometimes show a heel spur, but many people with heel spurs have no pain at all, so the spur is rarely the main cause.
How our chiropractors treat plantar fasciitis
Most people improve with conservative care, though it often takes several months. Depending on your exam, your plan may include:
- Custom orthotics — our chiropractors use the Footmaxx system to analyze how you walk and order custom foot orthotics that support your arch and reduce strain on the fascia
- Soft-tissue therapy and massage therapy for the arch, heel and tight calf muscles
- Foot and ankle joint mobilization where stiffness is changing the way your foot absorbs load
- A stretching and strengthening program for the calf, Achilles and the small muscles of the foot
- Acupuncture with our acupuncturist, which some patients use alongside other care for stubborn heel pain
- Footwear and activity advice so you can stay active while the tissue settles
If your pain doesn't improve with conservative care, we'll talk with you about medical options such as injections and refer you. Surgery is rarely needed. You can read about our overall approach on our chiropractic treatment page.
Self-care for plantar fasciitis at home
These simple steps help many people while they wait for their first visit:
- Stretch before your first steps in the morning — pull your toes back toward your shin for 30 seconds, a few times
- Stretch your calves against a wall twice a day, with the knee straight and then bent
- Roll your foot over a frozen water bottle for a few minutes to ease soreness
- Wear supportive shoes with cushioning, including at home, and avoid going barefoot on hard floors
- Cut back temporarily on running, jumping and long walks, and swap in cycling or swimming
- Try a night splint, which holds the foot gently stretched while you sleep and helps some people with morning pain
Pain on the back of the heel, rather than underneath, is more often linked to the Achilles tendon — see Achilles tendonitis. Runners may also find our article on avoiding running injuries useful.
When to seek urgent medical care
Get prompt medical attention if you have:
- Heel pain after a fall or jump and you can't put weight on the foot
- A red, hot, swollen foot, or a fever
- Numbness, tingling or burning in the foot, which can point to a nerve problem
- Heel pain that's constant at rest or at night
- Diabetes and a new sore, wound or color change on your foot
For the familiar morning heel pain that eases as you walk, a chiropractic exam is a good first step. Plantar fasciitis is one of the many conditions we treat.
