Causes of Plantar Fasciitis

 

Planter fasciitis is a painful inflammatory condition that affects the plantar fascia, which is the thick band of connective tissue running along the bottom of the foot. It’s very a common and very uncomfortable affliction that can be caused by a variety of factors, including the following:

Flat Feet
People who have flat feet are more likely to suffer from plantar fasciitis (heel spurs) than people who do not. As unlikely as it may seem any extreme deviation in foot shape can create difficulties that multiply over time.  The problem with flat feet is that they tend to over-pronate, which means that the ankle and foot roll inward toward each other while walking or running. This ‘rolling in’ motion places more stress on the medial (inside) part of the fascia. While many people pronate inward a little bit when they walk people with flat feet experience this type of movement to an almost exaggerated degree, and that is what causes plantar fasciitis.

High Arches

A foot with high arches is, oddly enough, at no less risk for developing these issues than a flat foot is. The problem is that this type of foot is prone to under-pronation, which is usually referred to as supination. This means that when walking or running every foot strike causes the weight to transfer to the outside of the foot only, which also causes an overload of stress to be placed on the arch of the foot. This particular range of motion can very easily cause plantar fasciitis and heel spurs, and high arches can also put enough tension on the plantar facscia to cause it to pull away from the heel.

Weak or Inflexible Foot Muscles

If the muscles of the foot are weak this can be a contributing factor in the development of plantar fasciitis and heel spurs as it causes imbalances and pressure points in the feet. If a muscle on the inside of the foot is weak you may tend to under-pronate whereas a weak muscle on the outside of your foot may cause you to over-pronate.

Inflexible muscles and tendons are a problem as well. For instance, if you have limited flexibility in your big toe it will prevent your foot from fully ‘rolling through’ the walking or running motion. This can strain the arch and/or cause you to land hard on your heels, both of which can contribute to plantar fasciitis and heel spurs.

Lack of Flexibility in the Calf Muscles

One of the easy-to-miss causes of plantar fasciitis (heel spurs) is lack of flexibility in the calf muscles. Studies have shown that people who have tight calf muscles run a 23% greater risk of developing this uncomfortable condition than people with sufficient flexibility. Tight calf muscles often cause pronation of the foot as well as repetitive over-stretching of the plantar fascia. This of course leads to inflammation which eventually leads to a thickening of the tendon and a painful case of plantar fasciitis.

Lack of flexibility in the calf muscles can also be caused by sitting excessively, (such as at a desk job), because the front of the foot is often pressed into the ground. This creates excessive stress in the arch of the foot that affects the heel as well. Conversely, people who stand for a living, such as nurses and store clerks, may also suffer tight calf muscles and plantar fasciitis because of the sheer volume of strain that is placed on their muscles and tendons. If this tension is not released it can lead to muscle stiffness that has a domino effect on the rest of the body, especially the feet.

Physical Inactivity

Being physically inactive for long periods of time puts you at increased for developing planter fasciitis for several reasons; the muscles of the feet may grow weak or rigid, calf muscles may be irritated by long periods of sitting, and any physical activity that is undertaken may cause injury as your muscles will no longer be conditioned to handle the extra stress of sudden heavy usage.

Even a ‘non-activity’ like pushing a stalled car to the side of the road may cause injury to the fascia due to the sudden and unexpected angle of the foot bending backward and the strain of calf muscle pushing forward, and the short, intense bursts of power needed to get the car rolling.

Being Overweight/Sudden Weight Gain

Carrying excessive weight or sudden weight gain increases the pressures on muscles, tendons and joints that are in no way prepared to support more pounds, all of which can cause stress and inflammation in the plantar fascia and related foot muscles.

Participation in Sports

There is no arguing that leading an active lifestyle is good for the mind and body but it comes with its own risks as well, and those risks increase if you’re playing sports or working out on hard, unforgiving surfaces. Aerobics, step-classes, long-distance running, running up and down stairs, and volleyball are some of the biggest culprits in the development of plantar fasciitis and heel spurs, as these activities put a lot of strain on the plantar fascia through repeated jumping and landing patterns and through repeated striking of the foot on a solid surface.

Lifting Heavy Objects/Squatting

Lifting heavy objects from the squat position is the correct and proscribed way to do it, but if all your weight is placed at the front of the feet it can cause the fascia to tear away from the heels. Even without heavy parcels to contend with many delivery-truck drivers experience plantar fasciitis because they constantly put pressure on the ball of the foot while climbing the high step to get into their trucks; this of course can also tear the fascia from the heel.

It’s important to remember that when lifting heavy objects you must shift your weight to your heels when rising from the squat position, and if you must climb steps regularly, or if you already suffer from plantar fasciitis, then it’s important to step with your heels as well as the ball of your foot. Any activity that routinely forces you to push off with the ball of your foot increases your risk of developing plantar fasciitis and—ironically—hell spurs, so be sure to use the whole foot during this type of activity.

Acute Injury

This type of injury is the result of a single event as opposed to long-term wear and tear. The plantar fascia can become detached from the heel bone suddenly, especially when you take off in a sudden run, or lunge forward from a stationary position. This type of acute injury often causes a ‘popping’ sensation or sound to occur. Plantar fascial ruptures are more likely to occur when there is a pre-existing case of plantar fasciitis, but it can go the other way as well; acute ruptures can also cause plantar fasciitis (heel spurs).

This kind of trauma can also result in fallen arches and a case of flat feet, both of which may to the development of planter fasciitis. Acute injuries of this nature are often the result of sports such as soccer or tennis, which demand abrupt lateral and forward motions.

Chronic Injury

Inflammation of the plantar fascia can occur from irritation and general wear and tear, and it may not be immediately obvious that the source of the discomfort is plantar fasciitis or heel spurs. Generalized heel pain, including a ‘bruised’ feeling at the back of the foot, and tightness or a ‘pulled feeling’ in the arch may be quite uncomfortable but will lack the sudden ‘snap’ of an acute injury; this doesn’t make it less debilitating or less important in terms of getting treatment. If there is blood vessel damage in the afflicted area it may be more difficult for plantar fasciitis and heel spurs to mend properly.

Footwear

Making a poor choice in footwear is one of the major causes of plantar fasciitis (heel spurs). Choosing poorly means wearing shoes without adequate arch support or proper cushioning, and/or shoes or boots that are too rigid and do not bend back easily at the toe. Wearing sneakers that are old or worn out is a bad ideas as well, as is wearing sneakers that are either too tight or lack proper support for the activity being undertaken.

Wearing high heels can cause problems with the fascia because too much strain is placed on the arches and heels, but switching abruptly from heels to flat shoes can also cause discomfort because tightened and shortened calf muscles are suddenly over-stretched and lengthened. As mentioned above, tight and inflexible calf muscles is one of the major causes of plantar fasciitis (heel spurs) and abruptly switching the height of your heel can wreak havoc on muscle function.

Low Centre of Gravity

Having a lower centre of gravity, or a centre of gravity that has changed due to pregnancy or weight gain has various side-effects on the body, and the development of plantar fasciitis (heel spurs) is one of the effects that can occur. Carrying excess weight for any reason changes the equilibrium of your body and places unnecessary strain on the tendons and ligaments in the feet. Losing weight is a good decision when it comes to your overall health but may be a necessary decision if you suffer from an inflamed plantar fascia and/or heel spurs.

Rigid or Poor Fitting Orthotics

Overly rigid orthotics can cause pain that is similar to that of an inflamed fascial tendon. It is often necessary to ‘break-in’ new orthotics devices so it’s best to habituate your feet slowly; try using your new inserts for 30 to 45 minutes per day for a few days, then gradually increase the time you spend wearing them until they have conformed to your foot and ‘softened’ a little.

No amount of ‘breaking-in’ can help you feel more comfortable with a poor fitting orthotic device however; if the shape or size of your insert does not match the shape or size of your foot this will cause more problems than it will solve. You should address the problem with your doctor or podiatrist as soon as possible. While poorly fitting orthotics do not cause plantar fasciitis (heel spurs) they also certainly will not relieve the pain you bought them to correct in the first place, and they may leave your with more foot pain than you started with.

Sciatica

Sciatica does not cause planter fasciitis or heel spurs but because the symptoms can be very similar we’re going to take a moment to address the issue. When there is pressure on the sciatic nerve it usually causes pain in the lower back and buttocks, but it can also strike the back of the upper thighs and then travel down the calf into the heel and sides of the foot, causing much confusion. If you’re experiencing serious heel pain, but you’re also experiencing pain in the back or the legs that is not symptomatic of planter fasciitis or heel spurs then your doctor may check for sciatic nerve issues.

Summary

There are many, many causes of plantar fasciitis (heel spurs) but by looking at this you may be able to better figure out what is causing your discomfort. I’m not a doctor of course, and you must consult your GP or podiatrist for diagnosis and treatment, but hopefully you’ve narrowed down the possible causes of your foot and heel pain.

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