top of page

Pain Profile: Plantar Fasciitis

Plantar fasciitis is the most common hindfoot problem in runners affecting about 10% of the running population (Anderson and Parr, 2009, p.672). Whether you like to run long distances, high intensity intervals, or something in between, plantar fasciitis can stop you from continuing to improve your fitness.

Anatomy

  • Tarsals – a group of bones made up of the calcaneus (heel), talus, navicular, cuboid, lateral cuniform, medial cuniform, and middle cuniform (foot bones). The tarsals are located in the posterior (back) of the foot and serve as attachment points for muscles, ligaments, and fascia (Anderson and Parr, 2009, p.640).

  • Metatarsals – a group of five bones located between the tarsals and the phalanges (toes) (Anderson and Parr, 2009, p.640).

  • Longitudinal Arch – a supportive structure to distribute body weight throughout the foot. The longitudinal arch runs from the calcaneus (heel) to the metatarsal heads (ball of the foot) and occurs on both the medial (inside) and lateral (outside) portions of the foot. The medial longitudinal arch is higher off the ground than the lateral longitudinal arch (Anderson and Parr, 2009, p.644).

  • Transverse Arch – another supportive structure to distribute bodyweight throughout the foot. The transverse arch runs across the anterior tarsals and metarsals (Anderson and Parr, 2009, p.644.)

  • Plantar Fascia – also called the plantar aponeurosis, the plantar fascia is an interconnected, specialized, and thick band of connective tissue that covers the plantar surface (bottom) of the foot to support the longitudinal arch. The plantar fascia acts like a spring to push the foot off the ground while walking and running. The plantar fascia can stretch 9-12% of its resting length during walking and running (Anderson and Parr, 2009, p.644-646.)

Plantar fasciitis occurs when the plantar fascia becomes overused and overloaded. An overload on the plantar fascia occurs when a training error occurs like doing too much too soon, not allowing adequate rest between training sessions, or improper periodization. Improperly fitting shoes, performing activities on unyielding surfaces like concrete or rocky surfaces, pes planus (flat feet), pes cavus (high arches), a tight Achilles tendon, and excessive pronation of the foot can also contribute to plantar fasciitis.

Signs and Symptoms

Some of the signs and symptoms of plantar fasciitis are sharp pains on the plantar surface (bottom) of the foot and medial (inside) of the heel with activity or weight bearing. In some cases of plantar fasciitis the pain may be relieved temporarily with certain activities but after cessation of the activity the pain returns. The pain may be the worst in the morning just after waking and within the first 10-20 minutes of waking. Pain may also radiate into the lateral (outside) foot. Muscle spasms in the foot and calf are common as well. The plantar surface of the foot will be tender when touching or massaging. Pain will increase if the toes are pulled into extension (pulling towards the shin) while the ankle is dorsiflexed (foot is flexed) (Anderson and Parr, 2009, p.644-672.).