USF-COM Department of Family Medicine

· Weight bearing activity - especially activities on hard, unyielding surfaces including exercise (walking, jogging, tennis) or work (waitressing, work involving long periods of standing.) Stress on plantar fascia is increased when these activities are performed regularly or when they are begun abruptly after long periods of physical inactivity.

· Age - as you age, the elasticity of the plantar fascia decreases leading to less arch support. There can also be atrophy of the fat pad covering the heel resulting in decreased shock absorbency.

· Weight - excess weight causes increased pressure on the feet, leading to increased stress on the plantar fascia.

 · Shoes - thin soles, poor arch support, and poor shock absorbency in footwear can be harmful. Regularly wearing high-heel shoes can lead to shortening of the Achilles’ tendon, which increases the strain on your heels and fascia when you change to a flatter shoe.
 

• Shoes - wear shoes that fit well, have shock absorbent soles, rigid shanks, and supportive heel counters. Wear proper shoes for each activity.
• Prepare for Exercise - warm up before exercising and stretch afterward.
• Exercise responsibly - Don’t ignore your body’s cues that you’ve done too much or have injured yourself (i.e. Pain!)
• Weight - learn what your ideal weight is and try to achieve it.  Adopt a proper diet and exercise program to maintain your weight.

· Choose alternative activities - decrease the amount of running, jogging, or walking and choose activities that put less weight on you heel such as bicycling or swimming.

· Ice - apply ice to the area for up to 20 minutes after acitivty.

· Strengthen - exercises to strengthen the muscles in your foot can help support your arch.

· Shoes - wear appropriate, well supporting shoes, with low to moderate heels, and good shock absorbency.

· Pain relievers - you can try over-the-counter (OTC) medications for the pain, use as directed on packaging, and taper their use as your pain is relieved.

· Weight loss - if you are overweight, losing the excess pounds will decrease the amount of pressure on your feet.

· Additional Support - you can try heel pads or cups to supplement the support and cushion of your shoes. There are several products availabe at medical supply, shoe and drug stores.

· Prescription pain relievers/anti-inflammatories - similar to OTC medications but require a doctors supervision for use due to side effects, especially gastrointestinal irritation.

· Night splints - devices worn at night that maintain a flexed foot position to keep the plantar fascia stretched.

· Corticosteroid injections - may help relieve inflammation when other steps aren’t successful. Like all injections they have the risk of infection and bleeding. More importantly, repeated injections are not recommended due to the risk of weakening the plantar fascia and promoting atrophy of the fat pad covering the heel.

· Surgery - very rarely indicated. Involves releasing the plantar fascia from the heel bone. Side effects include continued pain and weakening of the arch. As in all surgical procedures, there is a risk of infection, bleeding, and scarring.