By the time we're middle aged, many of us have experienced heel pain from plantar fasciitis. It's a pain and stiffness in our heel that's especially bad when we first get up in the morning or after we've been sitting for a long time. At best it's uncomfortable, and at worst it's disabling.

There are other heel pain causes (including heel spurs, tarsal tunnel syndrome, achilles tendonitis, and stress fracture) but plantar fasciitis is the most common.

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Heel Pain Causes: What is Plantar Fasciitis?
Plantar fasciitis involves inflammation and resulting pain in the thick band of connective tissue, called the plantar fascia, that runs lengthwise across the bottom (also called the plantar surface) of your foot, from heel bone to toes.

It usually causes a sharp, stabbing or burning pain in the arch of your foot, usually close to the heel. The pain is sometimes also felt behind the toes, and occasionally throughout most of the bottom of the foot. The pain is especially intense for the first few steps after you arise from bed in the morning, or after you've been sitting for a long time.

Heel Pain Causes: Why Does Plantar Fasciitis Happen?
Your plantar fascia normally acts as a shock-absorber for the arch of your foot. If it becomes over-tight, the overload on the tissue can cause micro-tears to develop. Repetitive stretching and tearing of the fascia can cause it to become inflamed and irritated/painful.

How does this repetitive stretching and tearing happen? As you lay in bed at night, the angle of your foot puts the muscle and fascia of your calves and plantar fascia in a relaxed, shortened position. The micro-tears start to heal, to knit back together.

Then when you get up in the morning, with your muscles and heel fascia cold and used to being in that relaxed, shortened position, your first step stretches the calf muscles and plantar fascia quite suddenly. That's just the normal mechanics of walking. But because your heel/foot tissue is inflamed, tender, and newly healing, the sudden stretch causes the plantar fascia tissue to re-tear. Ouch!

So--each night you heal, and each morning you re-tear/re-injure the plantar fascia. It's no wonder plantar fascitis has a reputation for being hard to heal!

Why does the whole cycle start in the first place? It's probably a combination of things. But here are some factors that put you at greater risk:

Some things that can contribute to this tissue stress, micro-tearing, inflammation and pain are:

• Activities that stress the tissue of your heel, including long-distance running, ballet, and aerobic dance.
• Being flat-footed or high-arched.
• Obesity.
• Spending long hours on your feet over a long period of time, especially on hard surfaces.
• Shoes that stress your feet, including those that have thin soles, lack arch support, lack shock absorption, or high heels.
• People between the ages of 40 and 60, and women, are also at greater risk for developing plantar fasciitis.

I wish you ease and comfort in your feet, and I am confident that you will be able to help yourself feel better.

(c) 2010 Nancy Hausauer

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