3 Signs You Have Plantar Fasciitis
- Dr. Angela Walk
- Jul 3, 2022
- 8 min read
Updated: Sep 16, 2024
If you suffer from Plantar Fasciitis you know how frustrating it is to get relief. Many people suffer from chronic foot, heel and arch pain for years and have tried countless traditional methods.
Most of these rehabilitation efforts fail because the focus in on diminishing inflammation. The current research has shown that plantar fasciitis is NOT an inflammatory condition, therefore anti-inflammatory attempts such as meds, cortisone shots, ice and rest provide no real correction.
I specialize in foot and gait mechanics and I have treated thousands of cases of plantar fasciitis. My goal is to help as many people suffering from plantar fasciitis and arm you with the tools you need to effectively treat plantar fasciitis.
Plantar fasciitis is already so painful the last thing you want is to make it worse. Let's take a look at the 3 signs to help you determine if you have this debilitation condition.
Dr. Angela Walk
"The Plantar Fasciitis Doc"
3 Signs You Have Plantar Fasciitis
To help you better determine if your heel pain is being caused by plantar fasciitis, here are 3 signs that will help you confirm the diagnosis.
1. Pinpoint tenderness on the inside aspect of your heel bone
The plantar fascia begins at your heel bone and fans out into your forefoot and attaches at the metatarsals. Take your finger and apply pressure to the inside portion of your heel bone. If this creates pain, this is the first sign you may have plantar fasciitis.
2. Pain with the first steps out of bed in the morning or after sitting for a prolonged period.
Pain with the first steps in the morning is the most distinctive feature of plantar fasciitis.
Also, if you have pain in the foot or heel with walking after longer periods of rest such as a long car ride or sitting at your workstation, that is another sign that you may have plantar fasciitis.
3. Pain in the arch with extension of the big toe (pulling the big toe toward the knee)
The third sign that you may have plantar fasciitis is pain with extension of the big toe. Pull your big toe up into extension. If this causes pain in your arch and heel, this is another positive test for plantar fasciitis.
What Are The Main Causes Of Plantar Fasciitis?
Wearing footwear with a narrow toe box or an elevated heel
Calf inflexibility or limited ankle mobility
Weak intrinsic muscles of the foot and arch muscles
Scar tissue and fascial adhesions in the plantar fascia and calf muscles
Now, let's take a look at each of these components and how we can correct them.
1. Wearing Ill-fitting Footwear
Ill-fitting footwear is the #1 cause of most foot and heel conditions including plantar fasciitis, bunions, hammer toes, and Achilles tendinopathy.
Avoid A Narrow Toe Box
The number one footwear mistake is wearing footwear that narrows or tapers at the toe, and I’m not just referring to women’s high heels. This includes men’s shoes, casual shoes, and even running shoes.
They all have narrow toe boxes. When we walk and run, our feet and toes should naturally spread and splay. When we are cramming our toes into footwear that narrows at the toe, it hinders the function of our feet and weakens our arch muscles overtime.
Avoid Elevation Of The Heel
Elevation of the heel in footwear is one of the most damaging characteristics, and it is present in most all footwear.
You would think that if most shoe designers added this feature there would be solid evidence to support the presence, but there is none. Elevating the heel causes excessive stress on the forefoot, because it places the foot in a downward angle
It also causes a chronic shortening of the heel cord (the Achilles tendon and calf muscles). So, it leads to tight calves and Achilles tendon issues.
Zero drop is the term used to describe a completely flat shoe from heel to toe. When a shoe has zero drop, it distributes body weight evenly across the foot and encourages natural arch support.
The Best Shoes For Plantar Fasciitis
In my program, the first footwear transition I recommend is to a pair of Altras. They are widest at the toe and zero drop.
They have moderate cushioning for comfort for those in the early phase of plantar fasciitis when symptoms are the worst.
Also, since most of you are accustomed to heavily cushioned shoes, they provide an easier transition.
When our feet become stronger from the strengthening and mobility protocols in my free guide, and from barefoot walking, I would like for you to consider a minimalist shoe.
I have compiled a list of approved footwear for plantar fasciitis. Following my recommendations may prevent you from wearing shoes that may be sabotaging your PF recovery. Dr. Angela's Recommended Shoe List.
2. Calf Inflexibility and Limited Ankle Dorsiflexion
One of the most common causes of plantar fasciitis is calf inflexibility and limited dorsiflexion. Dorsiflexion is the movement required when the toes are pointed up, or move toward your knee.
The primary cause of restricted ankle dorsiflexion is and calf muscle inflexibility. If there is not enough motion in the ankle joint, it causes perpetual tension on the plantar fascia.
The extra strain on the fascia leads to the break down of the soft tissues. Increasing motion of the ankle joint and calf muscle is imperative to resolve plantar fasciitis.
Exercises For Calf Flexibility and Ankle Mobility:
To increase ankle mobility and dorsiflexion, performing kneeling ankle rocks is the most effective exercise. Rock forward while keeping your heel on the ground. Hold each stretch for 2 seconds and perform 10-15 repetitions.
Increasing Calf Muscle Flexibility:
The best way to strengthen and lengthen the calf muscles (the gastrocnemius/soleus complex) is with calf raises. Using a ball between the heels targets a specific muscle that provides arch stability. Perform 3 sets of 15 repetitions twice daily.
3. Weak Intrinsic Foot Muscles
Another common cause of plantar fasciitis is weak intrinsic muscles of the feet. The foot relies on a complex system of muscles on the bottom of our feet to provide support and postural stability of the arch.
Proper and complete treatment of most foot conditions requires that the strength and control of these muscles be addressed.
One of the most common causes of weak foot muscles is wearing narrow toe shoes. When the big toe shifts inward, the muscles of the feet are unable to functional normally as we walk. This causes weakness overtime.
Also, another primary cause of weakness in the foot muscles is wearing foot orthotics. Using orthotics and built-in arch support deny our foot muscles the opportunity to work and creates lazy feet.
Barefoot walking is an excellent way to naturally strengthen your feet. I know, I know, I'm sure you have been told to avoid barefoot walking if you have plantar fasciitis, but walking barefoot is one of the healthiest things you can do for your feet.
Strengthen the intrinsic muscles of your feet with Short Foot Exercises as shown in the image below.
First, stand on both feet, and evenly distribute your body weight over the plantar foot.
Then, spread the digits. Make sure all toes are in touch with the ground.
Press the toes into the ground, and contract the arch of that foot.
Hold the short foot exercise for 2 seconds and repeat this 10-15 times. Perform daily!
4. Removing Scar Tissue & Fascial Adhesions
Scar tissue is also referred to as fascial adhesions, fascial restrictions, or simply “knots.” Think of scar tissue as the body’s duct tape.
When you walked too far in bad shoes, you overwhelmed the structural integrity of the plantar fascia and created small injuries. The body uses scar tissue like duct tape to create a quick “patch.”
Before the body can properly heal, you overwhelm the scar tissue patch, causing more scar tissue to be laid on top.
If fascial adhesions are present as in the case of plantar fasciitis, attempts to increase flexibility may only be temporary.
These fascial adhesions MUST be released before stretching is effective. Adhesions remain until they are removed. Rest, ice, stretching, and ibuprofen will not make them go away!
You may get some temporary relief, but once you resume your activities, the issue will make itself known once again. The best method to remove fascial adhesions in with a specific instrument.
I have used Instrument Assisted Soft Tissue Mobilization (IASTM) in my practice for many years with great success. I have extensive training in these techniques including Graston Technique and Gua Sha.
It involves the use of a stainless steel instrument or stone to "scrape" away scar tissue adhesions. These tools greatly assist in soft tissue mobilization and improve blood flow to the affected area and in turn, release adhesions in the muscle tissue and create healing.
Many plantar fasciitis rehab protocols involve using a lacrosse ball, tennis ball, frozen bottle of water, or foam roller to release fascial adhesions, but these objects are just not as effective.
Take a look at this article to learn more about what causes plantar fasciitis scar tissue and how to remove it.
Can I Treat Plantar Fasciitis At Home?
If you have this debilitating condition, here are my top 3 recommendations to get you started on your home rehabilitation.
Download my free guide. This is the first step on your PF recovery journey. I show you the exact steps to resolve plantar fasciitis at home.
Follow my social media pages. I offer daily tips, exercises, and the latest insights on PF. You can also connect and learn from others with the same struggles. Join us: Facebook page & Instagram
Take a look at my approved footwear guide. Dr. Angela's Recommended Shoe List and make sure you are not sabotaging your recovery with wearing the wrong shoes.
Because there is a so much misinformation out there about plantar fasciitis, I spend most of my time educating people on what NOT to do.
Most rehabilitation efforts fail because they are relying on cortisone shots, night splints, orthotics, ineffective stretching, thick, cushiony shoes, and rolling on a frozen water bottle.
These methods are either ineffective or just short-term band-aids, and do not provide long-term correction.
In my (6) step free guide, I offer solutions through addressing multiple factors. Improving footwear, identifying areas of weakness in the foot and ankle, and restoring proper foot function.
Summary
Dealing with the pain of plantar fasciitis can be life changing--but it doesn’t have to be a life sentence. By arming yourself with knowledge and taking charge of your healing, you can get back to the activities you love and feel like yourself again.
If you have additional questions about heel pain and plantar fasciitis, don’t hesitate to reach out. I'm here to help get you back on your feet--literally.
Best of Health,
Dr. Angela
I have also written extensively on the topic of Plantar Fasciitis. Take a look at these other related blog posts:
Hi, I'm Dr. Angela Walk
I have been involved in the health and wellness industry for over 25 years as a wellness physician, sports chiropractor, and foot health coach.
I have written for many health publications and I am keenly aware of trends and new developments.
I embrace an active lifestyle combining diet, exercise and healthy choices. By working to inform readers of the options available to them, I hope to improve your health and quality of life.
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