Plantar fasciitis is an inflammation of the thick connective tissue (plantar fascia) that runs between the heel and the toes. The plantar fascia is like a rubber band that contracts and stretches with each step. When too much stress is placed on the plantar fascia over time, tiny tears occur and the tissue become inflamed. Most commonly, patients complain of stabbing or burning pain in one or both heels when they get up in the morning because the plantar fascia has tightened up during the night. The pain usually subsides after a few minutes, but it may return later in the day, especially after long periods of walking, standing, or working out.
According to the Mayo Clinic, activities and conditions that cause tension on the arch of the foot can create small tears in the connective tissue, causing the fascia to become irritated or inflamed. Although opinions vary concerning the cause of plantar fasciitis, the American Academy of Podiatric Sports Medicine reports that a number of risk factors have been identified.
Age and Gender
If you are over 40, you are more likely to develop plantar fasciitis than a younger person, but there is no consensus about gender or the upper age limit for the at-risk population. For example, the Mayo Clinic describes the typical plantar fasciitis patient as a woman between the ages of 40 and 60, while the University of Maryland Medical Center says that males between the ages of 40 and 70 are more likely to develop the condition.
Exercise and Occupation
Activities that repeatedly place stress on the heel and attached tissue, including long distance running, ballet dancing, and aerobic dancing, increase your risk of developing plantar fasciitis. An increase in the duration or intensity of your workout routine can also cause inflammation in one or both feet. Your job may also put you at risk if it requires prolonged standing and walking. Nurses, teachers, food servers, and factory workers should take particular care to treat their feet well and to wear supportive shoes.
The plantar fascia is a shock-absorber, so any condition that increases the stress on the foot can put the patient at risk for developing plantar fasciitis. Conditions that cause people to walk unevenly, including mechanical problems with the feet, hips, spine, or ankles, increase the load on the foot, as do obesity and pregnancy. Diabetes and certain types of arthritis, including rheumatoid arthritis, are also risk factors for plantar fasciitis.
Wearing improper footwear will increase the risk of developing plantar fasciitis. Your feet need more arch support than ballet flats, flip-flops, or worn-out athletic shoes can provide. And wearing high heels tends to shorten the Achilles tendon over time, putting stress on the heel and the tissues around it.
Heel Spurs Not a Cause
The Mayo Clinic reports that there is no evidence to support the commonly held belief that heel spurs cause plantar fasciitis. Patients with heel spurs may or may not have plantar fasciitis, and there appears to be no causation link between the two conditions.
About this Author
Marcy Brinkley’s articles about health care and legal issues have appeared in “Texas Health Law Reporter” and the “State Bar of Texas Health Law Section Report.” She holds a bachelor’s degree in nursing, a master’s degree in business administration and a Doctor of Jurisprudence.