Overview of Plantar Fasciitis and Plantar Heel Pain

Plantar heel pain affects 10-15% of the population with an estimation of 2 million Americans visiting a physician due to heel pain affecting their quality of life. The popular term in regard to heel pain is plantar fasciitis, though the ‘itis’ in the term refers to an inflammatory condition which is not always the case.  The average duration of plantar heel pain is greater than 6 months in length, leading to a progression through the acute inflammatory stage to eventual chronic heel pain which would change the diagnosis to plantar fibromatosis or plantar fasciosis. These are terms you may see on a podiatrists prescription, however they all refer to plantar (sole of the foot) heel pain.

The plantar fascia is a fibrous structure attaching on the inside portion of your heel bone, the calcaneus, and extending to the base of each of your five toes. This creates a stabilizing ‘floor’ to the base of your foot as the tissue of the plantar fascia tensions in response to the force of your weight on the floor.  This is shown below, the plantar fascia is represented as the horizontal ‘truss’ to the foot in response to the floor’s force.  The force is dependent many factors; foot mechanics and foot position, speed of gait, running vs. walking, weight of the individual, prolonged standing, foot and ankle stiffness, and repetitive activities in weight bearing.

The force developed on the plantar fascia causes repetitive stress and strain it’s insertion on the inside portion or medial portion of the calcaneus.  Over time this stress and strain can lead to onset of bone formation at the heel often referred to as ‘bone spurs.’  Overall plantar heel pain develops from a poor relationship between the stress on the plantar fascia and its ability to handle the intensity, duration, or frequency of the stress we place on it every day. Continue reading