Plantar Fasciitis: What It Is and How You Get It

Houston podiatrist discusses Plantar fasciitis and heel spursPlantar fasciitis is one of the most common issues that I see in my Houston podiatry practice. It's a primary cause of heel pain, primary cause of arch pain, but it runs the gamut. There are some people who come in to see me who have been having their pain for two weeks, and I've see people who come in to see me who've had the pain for two years. Most people feel like it's going to go away on its own, but I'm here to tell you that it usually doesn't. In fact, you'll hear about sports personalities, famous sports personalities, who have to sit out part of or the entire season because of plantar fasciitis. It's a serious situation that you need to get on top of. In this video, I'm going to discuss what is plantar fasciitis, what causes plantar fasciitis and what a heel spur is and what does it mean if you have one. Welcome, I'm Houston podiatrist, Dr. Andrew Schneider

The plantar fascia is a broad ligament that it starts at the heel and extends through the entire bottom of the foot all the way to the toes and has two major and important functions. First, is the stability of the bottom of your foot. It's kind of there holding everything together. We think of a ligament, like an ankle ligament that we can sprain as one that just supports one particular joint. But this ligament supports the entire bottom of the foot. The second function is shock absorption. And so every step you take, whether you're walking or whether you're running that plantar fascia ligament pulls on your heel and that's where it can become inflamed. It often is inflamed, right where that ligament attaches to the heel, but it also can be inflamed anywhere along the course of the plantar fascia ligament. So some people feel pain in the heel and some people feel pain in the arch, but it's the inflammation that's what's causing the pain. 

Houston podiatrist treats plantar fasciitisAnother thing that is caused by the pulling of the ligament on the heel is the formation of a bony prominence called a heel spur. A heel spur forms in response to tension on the bone. So every time that ligament pulls on the heel, the heel will respond by laying down some new bone. And when we look on the x-ray, we'll see a hook of bone on the bottom of the heel, and that is called a heel spur. That's why sometimes plantar fasciitis is also known as Heel Spur Syndrome. I don't like that it's called that. It's called that because it's not the heel spur. In most cases that causes the pain. Yes. There can be some situations where it does, but in most cases, the heel spur is just a symptom of is going on. It's showing me that there's too much pull of that ligament and we need to find a way to calm it down. 

The reason I mention this is because people are afraid to come into the office with heel pain, because they're concerned if they have a heel spur and needs to be removed surgically. Well, I'm here to tell you that less than 5% of heel spurs actually need to be removed surgically. The vast majority of cases are just inflammatory. And if we're able to get the inflammation under control and continually controlled, then there's really no concern about surgery in cases like these. Another cause of plantar fasciitis is your foot mechanics. And it's an equal opportunity syndrome. It's going to affect people with both flat feet and high arched feet. It's the way that your foot function is going to dictate how much that ligament is pulling on your heel. So in a higher-arched foot, it's responsible for more shock absorption in a flat foot. It's going to have more tension because of the heel flattening and pulling on that plantar fascia ligament. 

But it's the mechanics of your foot that makes this inflammation linger. It makes it stick around longer than you think it should. Think about if you have a sore shoulder or a sore elbow, it goes away in a few days. But when you have this inflammation on your heel or in your arch, it can linger for days, weeks, months, and even years. And it's all because of the way that your foot functions.

There are common symptoms associated with plantar fasciitis. The most common that I hear are people who complain of pain with the first steps out of bed in the morning. That is a very common symptom called post static dyskinesia. Essentially what's happening is at periods of inactivity, whether you're in bed or sitting for a period of time, the ligament starts to heal itself and starts to kind of contract its way in. And when you step out of bed, it takes all that repair work that your body's done and pulls it apart. And you have that searing pain. First thing in the morning, often the pain will lessen as you start getting up and moving around and starting to walk. In some cases, it goes away. In some cases, it may not fully go away and you feel it throughout the day. Typically as the day progresses and you're on your feet, you're going to feel the pain get worse as the day progresses. And at night it's pretty painful. And you're typically going to find that you have a lot more pain if you're walking on a hard surface. You're going to have a lot more pain if you're barefoot. And you're going to have less pain, if you're wearing a shoe, especially a shoe that has support.

This is the first in a series of four videos focused exclusively on plantar fasciitis. In my next video, we'll discuss how plantar fasciitis is diagnosed. If this video provided any value for you, please like comment, subscribe, and share it on social media. That will help others find the information they need to get their heel pain feeling better. If you identified with anything we discussed today, contact us at the office and we'll schedule an immediate appointment. Thanks so much for watching and have a great day.