Plantar Fasciitis | Cedars-Sinai

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What is plantar fasciitis?

Plantar fasciitis is one of the most common causes of pain in the bottom of the heel, the arch or both areas. The plantar fascia is a thick, fibrous, ligamentlike band on the bottom of the foot. It is attached to the heel, runs forward along the foot and attaches again at the ball of the foot.

When the plantar fascia becomes irritated and swollen, the condition is called plantar fasciitis.

What causes plantar fasciitis?

With every step we take, our body weight comes to rest first on the heel and then gradually over the length of the foot. As the foot begins to bear weight, it flattens. This puts pressure on the plantar fascia, which has very little stretch. As we walk, the plantar fascia pulls on its attachment at the heel.

If the foot is properly aligned, this pull causes no problems. If the foot is pronated — meaning it rolls outward at the ankle — the arch falls too much and there is an abnormal amount of pull on the fairly rigid plantar fascia. This causes an abnormally strong pull on the heel where the plantar fascia attaches.

Something similar happens when the foot has supination, meaning it rolls inward. These type of feet are relatively inflexible, usually have a high arch and a short or unusually tight plantar fascia.

Plantar fasciitis can be caused by:

• A lack of arch support.
• A sudden injury.
• A tendency to roll your feet one way or another.
• An increase in activities such as running, basketball, tennis, soccer or gymnastics that involve repetitive pounding of foot.
• Being overweight.
• Doing a lot of walking barefooted.
• Having one leg that is shorter than the other. This causes the foot on the longer leg to carry the body’s entire weight longer than normal, stressing the fascia on that foot. Additionally, the foot of the shorter leg falls to the ground harder, putting more pressure on that foot.
• Poor flexibility in the calf muscle.
• Poor training for physical activities.
• Standing too long.
• Wearing shoes that don’t bend easily under the ball of the foot.
• Wearing shoes with too little cushioning.

It’s not always possible to identify the cause. Plantar fasciitis tends to develop as we get older and the fascia become less elastic. Women tend to get this condition more than men.

What are the symptoms of plantar fasciitis?

When you have plantar fasciitis, you usually feel pain in the bottom of the heel or the arch of the foot. Some people describe the pain as feeling like a bruise or an ache. The pain tends to gradually go away once you begin walking around. With continued walking, the pain may return, but usually goes away after rest. If the swollen plantar fascia irritated a nerve in the foot, pain may radiate into the ankle.

In the early stages of plantar fasciitis, the pain may go away quickly once you take weight off the foot. Over time, however, it may take longer and longer for the pain to go away. Without treatment, the plantar fascia will eventually tear partially away from the heel. The body fills the torn area in with calcium. This eventually becomes a bone and is called a heel spur.

How is plantar fasciitis diagnosed?

This condition is usually diagnosed on the basis of your description of your symptoms. Your doctor may examine your foot and its structure or look at your shoes to see how they are wearing. (Feet that pronate tend to break down the inner side of the shoe; feet that supinate tend to break down the outer side of the shoe.)

How is plantar fasciitis treated?

Depending on the individual, different treatments may be more effective than others. Approaches include:

• Rest. It can help to do ess weight-bearing exercise that involves running and jumping. Sitting or lying down and raising your feet can also reduce swelling.
• Applying ice. Using ice packs to cool (not freeze) your foot helps reduce pain and swelling. The ice should be used on heels and arches (not toes) for about 20 minutes three times a day. If you have diabetes or poor circulation, you should discuss this with your doctor first.
• Orthotics.
• Heel cushions. These off-the-shelf devices go inside your shoes.
• Splinting your foot at night.
• Avoid going barefoot.
• Stretching your foot.

Key points

• Plantar fasciitis is one of the most common causes of pain in the bottom of the heel, the arch or both areas. The condition comes on with inflammation of the plantar fascia, a ligamentlike band on the bottom of the foot.
• It’s not always possible to know which of the numerous causes of plantar fasciitis is at work.
• Rest, ice and heel cushions are some ways to treat the condition.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.

© 2000-2022 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.

Pain in the bottom of the foot

Pain in the bottom of your foot (arch, ball or sole) will often get better in a few weeks. See a GP if it does not improve.

How you can ease pain in the bottom of the foot

If you see a GP about pain in the bottom of your foot, they may suggest trying these things:

Do

• rest and raise your foot when you can

• put an ice pack (or bag of frozen peas in a towel) on the painful area for up to 20 minutes every 2 to 3 hours

• wear shoes with plenty of room for your feet that have a low heel and soft sole

• use soft insoles or pads you put in your shoes

• try to lose weight if you’re overweight

• try regular gentle stretching exercises for your foot and ankle

• use painkillers such as paracetamol or ibuprofen gel (or ibuprofen tablets if needed)

Don’t

• do not do any sports or other activity that you think is causing the pain

• do not walk or stand for long periods

• do not wear high heels or tight pointy shoes

A pharmacist can help with foot pain

You can ask a pharmacist about:

• the best painkiller to take
• insoles and pads for your shoes
• treatments for common skin problems, such as hard skin or a verruca
• if you need to see a GP

Video: exercises to reduce pain in the bottom of the foot

This video shows exercises that can help with pain in the bottom of the foot.

Media last reviewed: 17 April 2022
Media review due: 17 April 2025

See exercise video safety information

The exercises in this series of videos are suitable for most people in good health with a reasonable level of fitness.

Unless stated otherwise, they are general exercises only and are not aimed at treating any specific cause of pain or condition. Video titles and descriptions can give more information on how difficult the exercises are and who they are for.

Get advice from a healthcare professional before trying them if:

• you are not sure if the exercises are suitable for your current level of fitness
• you have a health problem, an injury, any symptoms, are feeling unwell, or you have had a recent health event such as a heart attack or operation
• you have any other concerns about your health
• you are pregnant or have recently given birth

Stop the exercise immediately if you feel any pain or become unwell. If you are concerned about any symptoms, or they do not go away, get help from 111 online or call 111 for advice.

Non-urgent advice: See a GP if:

• the pain in the bottom of your foot is stopping you doing normal activities
• the pain is getting worse or keeps coming back
• the pain has not improved after treating it at home for 2 weeks
• you have any tingling or loss of sensation in your foot
• you have diabetes and foot pain – foot problems can be more serious if you have diabetes

Immediate action required: Go to an urgent treatment centre or A&E if:

• you have severe pain in the bottom of your foot
• you’re not able to walk
• your foot has changed shape or is at an odd angle
• you heard a snap, grinding or popping noise at the time of injury
• you feel faint, dizzy or sick from the pain

These might be signs of a broken bone after an injury.

What we mean by severe pain

Severe pain:

• always there and so bad it’s hard to think or talk
• you cannot sleep
• it’s very hard to move, get out of bed, go to the bathroom, wash or dress

Moderate pain:

• always there
• makes it hard to concentrate or sleep
• you can manage to get up, wash or dress

Mild pain:

• comes and goes
• is annoying but does not stop you doing daily activities

Common causes of pain in the bottom of the foot

Pain in the bottom of your foot is often caused by exercise, such as running, wearing shoes that are too tight or a condition, such as Morton’s neuroma.

Some people also have a foot shape that puts extra pressure on the bottom of the foot. Hard or cracked skin or a verruca can also cause this type of pain.

Your symptoms might give you an idea what’s causing it, but do not self-diagnose. Get medical help if you’re worried.

Information:

Do not worry if you’re not sure what the problem is.

Follow the advice on this page and see a GP if the pain does not get better in 2 weeks.

Page last reviewed: 2 February 2022

Next review due: 2 February 2025

Foot sprain, treatment in Moscow

Foot sprain is a fairly common phenomenon. It occurs with a sharp turn of the leg inward. Clinically, sprain is manifested by pain during movement of the affected limb and on palpation, especially in the anterior part of the ankle, limitation of movement, swelling. The diagnosis is exposed on the basis of a clinical and radiological picture. The main points of treatment are to ensure the rest of the limb and the fight against swelling (applying ice, compression bandage, elevated position of the limb). In more severe cases, surgery is necessary.

Mechanism of injury

The ankle joint has the following ligaments, which are most susceptible to sprain:

• anterior and posterior talofibular;
• calcaneofibular.

There are 2 mechanisms of foot injury: inversion and eversion. In inversion (a more common mechanism), the foot is turned inward, resulting in damage to the most vulnerable lateral ligaments. In severe injuries, instability of the joint can form, which can cause additional sprains.

When eversion, the leg turns sharply outward, while the joint experiences excessive load. This mechanism of damage to the foot can lead to both sprains and fractures of the medial malleolus.

Diagnosis of foot sprain

When taking an anamnesis, patients note a fall on the injured leg or a sharp turn of the lower leg when the foot is fixed.

The main complaints of patients are:

• pain in the ankle joint;
• violation of motor function in the ankle joint.

During examination of the patient, the following signs of ligament sprain can be noted:

• forced position of the injured limb;
• swelling in the area of ​​injury;
• pain on palpation, aggravated by movement of the ankle joint;
• possible occurrence of bruising in the surrounding tissue;

Depending on the severity of the lesion, 3 degrees are distinguished:

• Grade 1: minimal soreness and swelling, tissues are weakened and prone to re-damage. Recovery takes several days.
• 2 degree: severe soreness and swelling, walking is difficult and causes pain. Recovery can last from several days to several weeks.
• 3 degree: swelling covers the entire area of ​​the ankle joint and may spread to the overlying areas. There may be bruising, as well as numbness of the foot due to nerve compression. Recovery lasts from one to one and a half months.

A stress test is performed to assess the integrity of the ligaments. It helps to make a differential diagnosis between 2 and 3 degrees. In the initial position, the patient sits or lies with bent knee joints. One hand of the doctor lies on the anterior lower part of the lower leg and pushes the lower leg backwards, the other – on the back of the heel, pushing it forward. Pain during this manipulation appears with a high sprain of the ankle joint.

The final diagnosis is based on the results of radiography of the joint in the anteroposterior, lateral, oblique projections. The picture reveals secondary signs of soft tissue stretching in the form of an enlarged joint gap, ligament divergence.

Treatment

The conservative RICE technique is used to treat sprains:

• Ankle rest;
• applying a cold compress to the affected area for 20-30 minutes;
• tight elastic bandage to improve blood flow and reduce swelling;
• elevated position above the hip joint. This will reduce soft tissue swelling by improving venous outflow. Reducing swelling will reduce pressure on the nerves and, as a result, pain.

Medical treatment includes non-narcotic and narcotic analgesics for pain relief and anti-inflammatory effect. The combination of tramadol and paracetamol is effective. Proton pump inhibitors (eg, omeprazole) are given to prevent stress ulcers. To improve microcirculation and soft tissue trophism, venotonics (troxerutin, venarus) are used.

In severe cases, limb immobilization and surgery may be required.

Prevention

Injury prevention consists in:

• compliance with safety regulations at home and at work;
• compliance with traffic rules;
• compliance with measures to prevent street injuries;
• creating a safe environment on the street, at home and at work;
• conducting an information and explanatory conversation about injury prevention measures.

Medical rehabilitation

The main physiotherapeutic methods of rehabilitation are:

• cryotherapy with a course of 5-10 procedures;
• ultraviolet irradiation with a course of 5-10 procedures;
• magnetotherapy with a course of 5-10 procedures;
• UHF-therapy with a course of 5-10 procedures;
• laser therapy with a course of 5-10 procedures.

To prevent atrophic changes in the muscles and improve the regional blood flow of the injured limb, use:

• isometric tension of the muscles of the thigh and lower leg for 5-7 seconds 8-10 repetitions with a gradual increase in the intensity of tension;
• active flexion and extension of the toes, lowering and raising the injured limb to improve peripheral circulation;
• ideomotor exercises to restore the dynamic stereotype.

Exercises for a favorable course of rehabilitation

1. In the initial position, sitting or lying with an injured heel, any letters of the alphabet are drawn. The more letters the better.
2. Tie one end of the elastic bandage to the foot and the other end to a chair or table. You should slowly pull the foot towards you, and then away from you for 1-2 minutes.
3. Another option with an elastic bandage: keep the knee straight, slowly pull the tape towards you until you feel a stretch in the calf muscle. Hold the position for 15 seconds and do 15 repetitions.
4. Stand one arm away from a wall. Put the injured leg behind the healthy one. Your toes should point forward in this position. Slowly bend your knees until you feel a stretch in the calf muscle. Hold the position for 15 seconds, relax, and then perform up to 20 repetitions.

Forecast

The prognosis for sprains is favorable. With grade 1 sprain, as a rule, healing occurs without residual effects. With sprains of degrees 2 and 3, tingling and pain in the joint can be observed in the long term, which may be caused by the involvement of nerve endings in the pathological process. Restoration of ligaments occurs due to scarring, which leads to their weakening. The connective tissue is not elastic enough, so the risk of re-injury increases. The patient is recommended to wear special supports.

Conclusion
Ankle sprain is effectively restored with the timely use of the RICE technique: rest, cold, compress and elevated position. With severe pain syndrome, analgesics are indicated.

Material checked by an expert

Mikhailov Valery Borisovich

Manual therapist, vertebrologist, neurologist

Work experience – 25 years

Foot sprain: causes, treatment, symptoms

Sprain foot ligaments – a common injury that can occur from – for injury, overexertion or unsuccessful movement. Symptoms of a foot sprain include pain, swelling, and restriction of movement. Treatment may include rest, ice, compression and elevation (RICE), physical therapy, and rehabilitation. This article looks at the causes, symptoms, and treatments for foot sprains to relieve pain and restore foot function.

A foot sprain is a disorder that can occur when the foot moves incorrectly or is injured. Foot ligaments are important structures that provide support and stability to the foot. When the ligaments are stretched or torn, pain and limitation of movement occur.

Foot sprains can be caused by various causes. One of the most common causes is improper movement technique or incorrect footwear. The wrong way to walk or run can lead to ligament overload and sprain. Also, poor-quality and uncomfortable shoes can put additional pressure on the ligaments of the foot, which can lead to damage.

Symptoms of a foot sprain include pain, swelling, bruising, and limitation of movement. Pain can be felt in the ligaments or in the entire foot. Swelling and bruising may appear within hours of the injury. Restriction of movement may manifest as difficulty walking or inability to fully extend the foot.

Treatment for foot sprains includes rest, therapeutic exercises, wearing special shoes, and applying an ice pack. Rest helps the ligaments to recover and avoid further damage. Therapeutic exercises help strengthen the ligaments and restore full range of motion. Special footwear, such as orthopedic insoles or supportive soles, can help relieve stress on the ligaments and improve foot support. An ice pack helps reduce swelling and relieve pain.

What is a foot sprain?

A foot sprain is an injury to the ligaments that connect the bones of the foot and keep them stable. The ligaments of the foot are an important part of the anatomy of the foot and play a key role in maintaining balance and locomotion.

Foot sprains usually occur when the foot is sprained or moves incorrectly, such as sports injuries or sloppy steps. It can be caused by a variety of factors such as strenuous exercise, improper footwear, or a defect in the biomechanics of the foot.

Symptoms of a foot sprain may include pain, swelling, bruising, and limited movement of the foot. An examination by a doctor, including a physical examination and additional tests such as x-rays or MRIs, may be required to diagnose and assess the extent of ligament damage.

Treatment for foot sprains usually includes wearing special shoes, applying cold and compression, taking anti-inflammatory drugs, and physical therapy. In some cases, surgery may be required to repair damaged ligaments.

What factors contribute to foot sprains?

Foot sprains can be caused by a variety of factors. One of the main factors is the injury that can occur when a fall, impact or improper movement of the foot. In addition, foot sprains can be caused by putting too much stress on the foot, especially when playing sports or exercising. The reason may also be imperfection of the anatomical structure of the foot, such as flat feet or a high arch of the foot.

Incorrect footwear is an important factor contributing to foot sprains. Wearing shoes with high heels or uncomfortable shoes can lead to undue stress on the foot and cause sprains. Also, wearing inappropriate athletic shoes can increase the risk of injury to the ligaments of the foot.

Obesity can also be a contributing factor to foot sprains. Excess weight puts additional stress on the foot and ligaments, which can lead to sprains. In addition, certain medical conditions, such as arthritis or gout, can contribute to the development of foot sprains.

All of the above can increase the risk of foot sprains, so it is important to pay attention to your foot and take steps to prevent injury. Regular exercise to strengthen the muscles in your foot, choosing the right footwear, and managing your weight can help reduce the risk of foot sprains and keep your feet healthy.

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What symptoms accompany a foot sprain?

Foot sprains are a fairly common injury that can occur during physical exertion on the foot or during unsuccessful movement. This condition is accompanied by a number of characteristic symptoms that suggest the presence of a sprain.

One of the main symptoms of a foot sprain is pain. Pain can be acute and localized in the area of ​​a damaged ligament or stretched muscles, or it can be widespread and pressing pain throughout the foot. The pain is aggravated by movement and palpation of the affected area.

In addition to pain, sprains in the foot can cause swelling and bruising. Edema occurs as a result of the accumulation of fluid in damaged tissues and may be visible to the outside. Bruises, or bruises, result from damage to blood vessels and form around the damaged area.

In addition, foot sprains can cause foot movement limitation and muscle weakness. The affected foot may be unable to support the load, resulting in difficulty walking. Also, there may be a feeling of instability and an unpleasant sensation when trying to flex or extend the foot.

Diagnosis of foot sprains

Diagnosis of foot sprains is an important step in determining the extent of damage and choosing the right treatment. To do this, the doctor conducts a comprehensive examination of the patient, including history, physical examination and instrumental studies.

During the anamnesis, the doctor finds out the circumstances under which the foot sprain occurred, as well as the nature and severity of the injury. This allows you to determine the possible causes and mechanism of damage.

Physical examination includes visual assessment of the foot, palpation and functional tests. The doctor pays attention to the presence of edema, hemorrhages, changes in skin color and violations of the axis of the foot. On palpation, tenderness and localization of pain points are assessed. Functional tests help determine the limitation of foot mobility and possible ligament dysfunction.

For a more accurate diagnosis and assessment of the degree of damage to the ligaments of the foot, instrumental studies can be prescribed. X-ray allows you to exclude fractures and assess the condition of the bones of the foot. Magnetic resonance imaging (MRI) and computed tomography (CT) provide detailed images of the ligaments and soft tissues and determine the extent of damage.

As a result of the examination, the doctor establishes the diagnosis of foot sprain and determines the degree of damage. This allows you to develop an individual treatment plan, including conservative methods or, in rare cases, surgery.

How is a foot sprain treated?

Treatment for foot sprains depends on the extent and nature of the injury. In most cases, treatment begins with the application of cold and pain medication to relieve pain and inflammation. It is important immediately after injury to apply a cold compress or ice to the foot for 15-20 minutes every 2-3 hours for the first few days.

To improve blood circulation and accelerate tissue regeneration, massage and physiotherapy treatments such as ultrasound and laser treatment can be used.

To support the ligaments and prevent re-injury, it is usually recommended to wear special orthopedic insoles or bandages. They help reduce stress on the foot and prevent unnecessary movement.

More severe sprains, where the ligaments are completely torn, may require surgery. The doctor may recommend surgery to repair the ligaments and strengthen the foot.

After the treatment of a sprained foot, it is important to carry out rehabilitation exercises aimed at restoring the strength and flexibility of the foot. Physical therapy and stretching exercises can help restore foot function and prevent recurrence of the injury.

In any case, in case of a foot sprain, it is necessary to consult a doctor who will diagnose and prescribe the appropriate treatment, depending on the nature and degree of damage.

Physiotherapy and rehabilitation after foot sprains

Physiotherapy plays an important role in the recovery process after a foot sprain. It helps strengthen and repair damaged ligaments, improve blood circulation and reduce inflammation.

One of the main methods of physiotherapy is therapeutic massage. Massage helps to relax muscles, improves their elasticity and flexibility. Also, massage helps to improve blood circulation in the damaged area, which contributes to the rapid restoration of foot ligaments.

To strengthen and restore the ligaments of the foot, exercises for the legs and lower legs are often used. They are aimed at developing the strength and flexibility of the muscles of the foot, as well as increasing stability and balance. Exercises may include stretching, squeezing and unclenching the legs, as well as working with an expander or rubber bands.

Physiotherapy treatments such as ultrasound and electrical stimulation are also widely used. Ultrasound therapy helps speed up the healing process of tissues and reduce inflammation. Electrical stimulation helps to strengthen muscles and increase their tone.

An important element of rehabilitation after foot sprains is the wearing of support bandages or orthoses. They help reduce stress on the injured foot and prevent re-sprains.

Physical therapy and rehabilitation after foot sprains should be supervised by a specialist and be individually selected depending on the extent and nature of the injury. Compliance with all recommendations and regular exercises will help you return to normal activity faster and more efficiently and avoid complications.

Foot Sprain Prevention

Foot Sprain is an unpleasant and painful condition that can be prevented with a few simple steps.

First, regular stretching and strengthening of the foot muscles will help prevent sprains. It is recommended to perform exercises aimed at strengthening the muscles of the lower leg, foot and lifting the arch of the foot. Exercises such as calf raises, flexion and extension of the foot will help improve the flexibility and strength of the foot, which will reduce the risk of sprains.

Second, wear suitable shoes. Avoid shoes with high heels or flats, as these can affect the foot and increase the risk of sprains. The best option would be shoes with a small heel and good foot support.

Thirdly, watch your weight. Being overweight puts additional strain on the foot and can contribute to sprains. Regular exercise and a healthy diet will help you lose weight and improve your overall health.

It is also recommended to avoid sudden movements and overloads of the foot, especially when playing sports or physical activity. Gradually increasing the load and the correct exercise technique will reduce the risk of sprains.

It is important to remember that preventing foot sprains is an important part of a healthy lifestyle. Compliance with simple recommendations will help to avoid unpleasant consequences and maintain the health of the foot.

When should I see a doctor for a foot sprain?

A sprain in the foot, especially if it is accompanied by severe pain, swelling and impaired movement, you should consult a doctor. The doctor will conduct an examination and diagnosis to determine the extent of the damage and prescribe the appropriate treatment.

You should also see a doctor if a foot sprain is caused by injury or unusual stress, such as a fall, sports training or strenuous physical activity. The doctor will be able to assess the possible consequences and recommend the necessary measures for a quick recovery.

If a foot sprain causes symptoms such as severe pain, swelling, bleeding, or a feeling of instability in the foot, medical attention is urgent. The doctor will be able to rule out possible damage to bones, joints, or other tissues that may require more serious treatment.

You should also see a doctor if the symptoms of a foot sprain do not improve or get worse over time. The doctor will be able to review the treatment plan and prescribe additional measures to relieve symptoms and speed recovery.

Q&A:

What causes a sprain in the foot?

Foot sprains can be caused by improper footwear, strenuous physical activity, trauma or damage to the foot.

What symptoms accompany a foot sprain?

Symptoms of a foot sprain include pain, swelling, bruising, limitation of movement, and curvature of the foot.