What is plantar fasciitis?

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Plantar fasciitis is primarily one of repeated stress to the fascia rather than one of inflammation. The plantar fascia is a tough band of fibrous tissue which has its origin at the medial calcaneal tubercle and extends distally with projections over each of the five metatarsal heads plantarly. The plantar fascia is felt to play a major role in maintaining the normal arch, and as such, is subjected to a great deal of stress when a load is placed on the foot. As one might expect, this stress history can give rise to pain within the plantar fascia when there is degeneration of the plantar fascia with subsequent inflammation ensuing. The inflammatory nidus and degenerative locus tends to be at the origin of the plantar fascia, but pain is described both in this region in the mid substance of the plantar fascia. Often a small tear results from excessive strain placed on the plantar fascia. Plantar fasciitis is one of the most common causes of heel pain. Pain may occur anywhere along the course of the plantar fascia but most commonly is located where the fascia joins the bottom of the heel bone. Many people who develop the disorder have very high or very low arches in their feet. Tight calf muscles or a tight Achilles tendon (which attaches the calf muscles to the heel bone) may cause the foot to flatten, which can lead to a painful "bowstringing" of the fascia.

Plantar fasciitis is common in obese people and in pregnant women, perhaps because their extra body weight overloads the delicate plantar fascia. It is also more common in people with diabetes, although the exact reason for this is unknown. Plantar fasciitis tends to affect those over 30 years of age to a much greater degree than those younger. This probably is a consequence of age-related degeneration of the plantar fascia as well as gradual loss of elasticity in these tissues.

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