Plantar Fasciitis is one of the most common causes of heel pain. It involves the tough band of connective tissue (“Fascia”) that inserts into a relatively small area of the heel bone, and then fans out to connect around each of the five metatarsals. This normally creates a springy arch mechanism called a “windlass effect” whereby off weightbearing, the fascia has little tension in it – but then is tasked with maintaining the longitudinal arch from front to back when standing or walking. 

It’s not always clear why it gets swollen and irritated, but the incidence of Plantar Fasciitis is greater in people with misalignment of the arches, tight calf muscles, especially the Achilles tendon, and those who are overweight. It can also result from repeated high impact activities like running, tennis, and dancing. A heel spur can form as the body attempts to stabilize the insertion of the fascia into the heel, and chronic inflammation is created under the arch at the point of the heel fascial insertion. The pain is usually worse first thing in the morning, after prolonged sitting, and is aggravated after repeated high-impact activities. Typically, the fascia will contract and tighten when you are sitting or lying down, and then be forced to once again lengthen and potentially try and tear loose from the heel once you stand on that foot.  The fascia has minimal stretch to it, and yet your foot has broken down and is typically a longer length, creating a challenge for the fascia to stretch and lengthen as much as the boney arch has collapsed.