Plantar fasciitis (“Plan-TER FASH-EE-eye-TUS”) is the most common cause of heel pain seen in people who are very active on their feet. It is often seen in athletes; people who are active at work, and in large framed or overweight individuals. It begins as a dull ache or intermittent pain in the heel and sometimes progresses to a sharp persistent pain. Classically, it is most evident in the morning when you first get out of bed and put weight on your feet, then resolves with some walking. It is also noticed at the beginning of sports activity or by standing up on the feet after sitting for a period of time. The plantar fascia is a thick band of tissue on the bottom of the foot. It is attached to the bottom of the heel bone, fans forward towards the toes, and acts like a “bowstring” to help maintain the arch. When a small portion of this inflexible fascia band is repeatedly placed under tension, the injury occurs. Tension causes an overloading or tearing, usually at the point where the fascia is attached to the heel bone resulting in inflammation and pain. Since it is difficult to rest the foot the problem continues to build and worsen with every step. Contributing factors include having extremely high or low arch, wearing shoes with poor support, a sudden increase in weight or activity. Increasing age, or family tendency can also be contributing factors. Treatment should be started as soon as possible. If left untreated, the continuous inflammatory reaction at the heel bone may produce “spike-like” projections called heel spurs. Early conservative treatment usually involves anti-inflammatory medication and injections, custom orthotics, stretching, night splints, strapping, physical therapy, proper shoe gear, and activity. Resistant deformities may require treatment with non-surgical shockwave therapy, or possible surgical intervention for release of the fascia band and spur removal. If symptoms or heel pain arise, do not hesitate to have this condition properly evaluated and treated by our ankle and foot heath care professionals.