Have you every woken up in the morning and to take those first steps out of bed and experience pain in your heel and bottom of your foot? You could be experiencing plantar fasciitis symptoms. These symptoms mainly present themselves first thing in the morning, but can span across the rest of the day. The main question is if you are dealing with this heel and foot pain first thing in the morning, then what can you do about it? This article will review what plantar fasciitis is and the common symptoms you can experience, risk factors, and will explore effective treatment options for plantar fasciitis.
**This is not medical advice. Please consult your medical provider for more information.
Understanding the Plantar Fascia
The plantar fascia is a thick band of connective tissue that runs across the bottom of the foot. It starts at the base of your heel and runs up towards your toes. The plantar fascia provides support to the arch of your foot and helps with shock absorption.
It is important to remember that the plantar fascia is not a muscle, so it does not contract. It can be stretched though. Plantar fasciitis refers to inflammation of the plantar fascia. It can become inflamed through overuse, non-supportive footwear, and sudden increases in time on your feet. Plantar fasciitis is an extremely common condition and 1 in 10 people will develop it at some point in their lifetime.
Common Symptoms of Plantar Fasciitis
When you first step out of bed in the morning, do you experience a sharp, stabbing heel pain? This could be one of the first plantar fasciitis symptoms you experience. Plantar fasciitis has multiple symptoms to be on the lookout for. One of the most common is heel and/or arch pain. You may also notice that it hurts a lot worse when taking your first steps either in the morning or after sitting for a long time.
Stiffness within the bottom of the foot or the ankle may be present. Occasionally, you may notice some swelling near your heel. All can be signs of plantar fasciitis.
If you ignore the symptoms, it can progress into worse pain or more to other areas, like in the ankle or Achilles tendon. It can also make it more challenging to treat the longer it goes on, as plantar fasciitis can be stubborn to treat. Keeping an eye on these symptoms can save you from prolonged discomfort.
The First Steps Out of Bed: A Telltale Sign
Perhaps the most common symptom is the sharp, stabbing heel pain when taking your first steps in the morning. While the pain can also be in the arch of the foot, it usually starts right at the base of your heel. The thick band of tissue that is the plantar fascia signals tot he body that it is inflamed, thus causing the pain with your first steps. This is the hallmark sign of plantar fasciitis.
Your first steps stretch the inflamed tissue, resulting in acute heel pain. This phenomenon is a direct consequence of the plantar fascia’s inability to immediately provide the support that is required of it. It is important to recognize and treat plantar fasciitis symptoms early to avoid potential chronic pain later down the line.
Pain That Progresses
If you have been dismissing the persistent heel pain or discomfort in your foot, it is important to understand that change needs to happen. These symptoms can intensity and spread. Commonly, we brush the foot pain off to the side. You experience pain in your heel taking your first steps in the morning because after just a few steps, it goes away. You notice it is there every morning though. But it continues to go away and we keep brushing it off.
Before you know it, you realize it has been doing this for weeks, or worse, months. The pain is lasting longer in duration or it isn’t even going away now. There’s more pain at the end of the day after you’ve been on your feet all day. This is exactly how that morning foot pain can evolve into chronic pain that lingers with every step you take. What starts as a dull ache can soon become a sharp stabbing pain with each movement. Running injuries or even simple daily activities like walking become daunting tasks.
The hard part with plantar fasciitis is that we have to use our feet every day. They provide us with movement and locomotion. So giving your feet a rest break isn’t going to work. And then what happens when you do have to move after that rest break? You know that pain that is going to ensue after that. This is where plantar fasciitis can be stubborn to work with. Your best option is to catch the symptoms early. If you are someone who is already dealing with the chronic state, don’t worry. There are still effective treatment strategies that can help!
If you are dealing with plantar fasciitis and want to speak directly to me, a physical therapist, so we can get rid of that nagging pain when you first take your steps in the morning, schedule a FREE 30 minute consult! Let’s get you walking without feeling like you’re walking on eggshells.
What Causes Plantar Fasciitis?
While there is no direct cause and effect line to be drawn straight to plantar fasciitis, there are scenarios that may increase your risk of developing it. This does not mean that if you do these things, you will develop plantar fasciitis. It simply means that there is a positive correlation, meaning that it increases your likelihood of potentially developing plantar fasciitis.
Plantar fasciitis refers to inflammation of the plantar fascia. This is important as it can clue you in to what could be leading to some of your symptoms. Anything that places extra stress onto the bottom of you foot can potentially lead to irritation and/or inflammation. Repetitive movements can lead to plantar fasciitis due to repetitive foot and heel strikes. This can be running, dancing, or walking at home on a hard surface without shoes on. Occupations requiring long durations on your foot can also predispose you to plantar fasciitis. Ill-fitting footwear or non-supportive footwear can also be a contributing factor.
There are also a few conditions that can predispose you to plantar fasciitis. Having either high arches or flat arches can increase your likelihood of developing it due to the increased stress going down to the bottom of the foot in both cases. This is why having supportive footwear based off of what you need is important.
Diagnosing Plantar Fasciitis
Your healthcare provider can provide a diagnosis of plantar fasciitis typically after performing a physical exam. They’ll take account of the symptoms you are experiencing, including the heel pain that is worse when first walking in the morning. They might also ask what types of shoes you wear and how often you are on your feet each day. If plantar fasciitis is suspected, the physical examination can help confirm. This includes finding the tender spots around the heel and bottom of the foot. While plantar fasciitis is very common, it is important to confirm that this is the reason you are experiencing the pain. There are many other reasons why you could be experiencing pain in your heel or foot, so it is important to rule out all other possibilities.
Imaging is used if the diagnosis isn’t clear or to rule out other potential causes of your pain. Imaging can provide a detailed view to confirm inflammation within the plantar fascia and exclude other potential causes, such as a tear in the plantar fascia or bone spurs. Most of the time, imaging is not needed for plantar fasciitis. However, this comprehensive approach can ensure a treatment plan that is right for you and is tailored to your specific needs.
Treatment Options for Plantar Fasciitis Symptoms
Physical therapy is often the first line of defense when dealing with plantar fasciitis. Oftentimes, inflammation of the plantar fascia comes from having a demanding job that requires you to be on your feet for long periods of time. In cases like this, education becomes a cornerstone for treatment. It involves educating why this happens and troubleshoots ways to help manage the amount of stress going to the plantar fascia. Other times, in an evaluation, I see poor biomechanics and poor foot posture. Treatment then becomes geared towards correcting the postural impairments that are leading to the extra stress on the bottom of the foot. In most cases, treatment involves a blend of both education for symptom management and correcting foot posture.
What Do Physical Therapists Look for?
What exactly are we, as physical therapists, looking at for good foot posture and biomechanics? It all comes down to watching how you stand and walk. As movement experts, we can analyze how you move to determine where faults lie and what needs to be addressed to make the appropriate corrections.
First, we want to see you stand still without shoes on. We can see what the arch of your foot looks like under load, the direction your feet point when you’re standing, and where your weight distribution is on your feet. Lifting the big toe can also give us good information about the windlass mechanism, which is very important for the way your foot functions.
Then, we will watch how you walk without shoes on. That way we can see what is happening with your foot, ankle, and the rest of your leg as you are moving and as you are under load. We will compare this to what we see when you are standing still. Sometimes, things change when you are standing still versus moving. We can also view how different joints are moving and if there are any restrictions somewhere in the lower extremity chain. Sometimes problems with the foot can translate to compensations in the knee, hip, or back.
Personally, I also like to watch how the foot performs under increased loads. If appropriate, I will ask someone to either sit and stand or perform a bodyweight squat to see what is going on with their foot. I will also like to observe single leg heel raises. This can tell me information about what muscles you do (or don’t) like to use and where strength deficits may be present. Taking all of this information, I then confirm my observational findings by performing range of motion, joint mobility, or specific strength tests on the table. This finalizes what impairments are present and what needs to be done to correct it, which ultimately forms the treatment plan for plantar fasciitis. Check out THIS blog post to start with some exercises for plantar fasciitis!
Other Helpful Articles Related to Foot/Ankle Pain
- Pain When Walking First Thing in the Morning? Try These 7 Exercises for Plantar Fasciitis
- Understanding the Connection Between Foot Posture and Back Health
- A Complete Guide to At-Home Bunion Treatment
- Unlocking the Role of Big Toe Extension
- Managing Pain in the Back of the Ankle
- Ankle Pain When Walking? Why it Hurts and How to Fix It
Other Treatment Options
In more chronic cases, shoe inserts or orthotics can be beneficial. They help provide the necessary support and adjust to what your foot needs to give the best mechanical advantage. Orthotics can also be used in conjunction with physical therapy.
Plantar fasciitis symptom and pain management can be included at home with relatively no extra charge to you. Freezing a water bottle and rolling your foot out on it can help with the inflammation and reduce pain levels. While this doesn’t always work for everyone, trying it out won’t hurt (don’t do this if you have a cold sensitivity or have reduced sensation in your feet).
If you have tried all options presented above with no improvement in your symptoms, seeking alternative options through your healthcare provider may be indicated.
Preventative Measures for Plantar Fasciitis
While there is no way to know if you will ever develop plantar fasciitis, understanding the risk factors can help you become more cognizant of what you should or shouldn’t be doing.
Make sure to wear supportive footwear, especially if you are on your feet a lot. While your muscles should have the strength to carry you the large majority of the time, we all still have our limitations. Supportive footwear can help out when your muscles fatigue.
Foot posture is important to pay attention because making small adjustments here can help significantly reduce risk of injury or developing overuse issues. Making sure you have adequate strength in your calves, peroneals, and foot intrinsic muscles is advantageous. You also want adequate mobility in your big toe and your ankle. More specifically, you want to ensure you have big toe extension and ankle dorsiflexion. Lacking ankle dorsiflexion and big toe extension correlate with many conditions, including Achilles tendinitis, Achilles tears, and sprained ankles. Incorporating exercises targeting these areas can be a powerful preventative measure.
Lastly, understanding and respecting the limits of your body plays a crucial role in preventing plantar fasciitis. If morning foot pain is a symptom you’re already experiencing, it might be worth consulting with your doctor sooner rather than later.
When to Seek Medical Help
If every step is painful and is progressing from heel pain throughout the bottom of your foot, it is a sign to reach out to your primary care physician. If you have also tried conservative measures like shoe inserts, modified your activities, and participated in physical therapy with little to no improvement in symptoms, this is also a clear sign to seek further follow up from your doctor.
Ignoring these symptoms can lead to more severe complications over time. It can take manageable pain into a potentially chronic condition. The goal is to not only address the inflammation and discomfort, but also correct any underlying issues contributing to your plantar fasciitis. By consulting with your primary care physician early, you are taking vital steps towards regaining foot function and preventing future issues.
TL;DR
Plantar fasciitis symptoms mainly present themselves first thing in the morning when you take your first steps. It can cause sharp pains in your heel and can progress to pain along the arch. Plantar fasciitis is extremely common and has multiple contributing factors. This article reviews what plantar fasciitis is and the common symptoms you can experience, contributing factors, and how physical therapy can help reduce the pain you experience from plantar fasciitis.
