There is about a 10% change you will develop plantar fasciitis pain in your lifetime. Are you at risk? Want to know what causes plantar fasciitis pain? Here are 3 factors that put you at risk.
3 Risk Factors for Plantar Fasciitis Pain
Decreased Ankle ROM
On your feet all day
Obesity
#1 Decreased ankle motion can cause plantar fasciitis
Missing motion in the foot, especially dorsiflexion, can alter walking mechanics and cause extra stress to the plantar fascia. This is a classic “overuse” mechanism that can lead to pain.
This can also lead to reduce motion of the big toe and alter the Windlass Mechanism, which is 50% of the foots job.
Here’s a video on how to improve ankle and toe motion. The front foot is working dorsiflexion, the back foot toe extension.
#2 On your feet all day
Its easy to blame foot type (flat, arched, etc), but usually its TOTAL time on your feet, not your general foot shape.
#3 Obesity is a risk factor for plantar fasciitis
This may be the elephant in the room, but obesity increases your risk factor for plantar fasciitis (and MANY other issues) because
Decreased healing ability because of full body inflammation
The foot is working harder because of extra weight
Low activity tolerance/general fitness
Other co-morbidities you may have
If you are heavier and dealing with plantar fasciitis pain, be sure to only exercise to tolerance.
Pain during exercise is okay, general guidelines for pain during exercise are:
don’t let pain exceed +2/10 of your baseline; meaning if baseline is 2/10, don’t let it EXCEED 4/10
don’t let pain exceed 5/10 on an absolute scale
pain should NOT be worse your next exercise session
Summarizing the causes of plantar fasciitis
Plantar fasciitis can be pretty painful. The treatment for this condition is “easy,” but managing the causes of plantar fasciitis can be a real challenge. Step 1 is knowing what your risk factors are, then working to reduce those factors. Learn how to treat plantar fasciitis
How Do You Fix Plantar Fasciitis?
Strengthen the plantar fascia
Restore blood flow
Weigh less
Dry needling/ injections
Strengthen The Plantar Fascia
All tissue, regardless of what type (bone, muscle, tendon, ligament) can be strengthened. This holds true for the plantar fascia as well. See video below. The big toe dictates how the foot functions a great deal.
Allowing the big toe to extend during a calf raise ensures the plantar fascia is strengthened through its entire ROM
Perform 3 sets of 15 reps in a double leg stance
If this is easy then perform the same rep scheme in a single leg stance
Progress by adding reps first and then weight
Restore Blood Flow To The Plantar Fascia
This can be accomplished by 3 different methods, all of which I have seen work well in real life application.
Scraping (Graston, IASTM)
Rolling with a lacrosse ball
Night splint
Scraping
Scraping is a technique in which you apply a force to the tissue which in turn stimulates healing and blood flow
Scrape the plantar fascia (bottom of foot) for 3-5 minutes a day
Scraping is unpleasant in the moment but afterwards you will feel better
Rolling with a lacrosse ball
Night splint
I see good results with a night splint on patients in the real world
Wear this every night to keep the plantar fascia lengthened while you sleep
See the image below for a quality night splint
Weigh Less
This is the part you may not want to hear but you need to. Don’t yell at me. This isn’t my fault
Having a BMI over 27 is the single best predictor for developing plantar fasciitis. Lose some weight and I guarantee your foot will feel better
There are plenty of other ways to exercise and burn calories. Getting foot pain every time you run is not a solution. If running is something you insist on, take a short break and find another cardio machine (bike, elliptical)
Dry Needling
Dry needling falls along the same concept as scraping from above. Small needles are put into the plantar fascia. These cause a small amount of trauma to which the body responds by increasing blood flow to increase healing.
The reason this is in this section is that a medical professional has to do this procedure.
Corticosteroid Injection
Corticosteroid injection is another alternative treatment for plantar fasciitis. However this should be the final measure taken. Although the injection has a good chance to decrease the pain, it increases the risk of plantar fascia rupture. This is only included as an education piece. I do not recommend this procedure.
Plantar fasciitis can be a very painful condition but this guide will fix that issue for you. It is not an overnight fix but the pain should resolve in a few days/weeks.
Hopefully you find this helpful. If you need more for plantar fasciitis, we have a complete guide available here.
I’m so happy to see a post on PF! I deal with this so much. Your recommendations are excellent, but I would offer a couple of additional things....
My podiatrist told me that changing shoes every couple of hours for people who are on their feet all day can really help the discomfort, since the foot won’t be in the same position for hours on end. Alternating between 2 pairs of shoes is fine, you don’t have to bring your whole shoe wardrobe to work. It’s not rehab, but it can help someone get through the day.
Doing medical massage, PF is something I work on a lot. In my experience, it’s highly correlated with the soleus. I don’t know which is the chicken or the egg, the fascia or the soleus, but both seem to always be involved.