Understanding Plantar Fasciitis (Heel Pain)

Plantar fasciitis is the most common cause of heel pain, and it is epidemic in Central Texas. People suffering from plantar fasciitis commonly report a sharp, crippling pain in their heels when they first get out of bed. The pain gradually subsides as they continue walking but a residual soreness is usually present. As the day wears on, the pain can continue to increase, and at the end of the day, you feel miserable.

About 50 percent of our customers at Total Relief Footwear suffer from plantar fasciitis. Many of our customers have little understanding of their ailment. They know that they are in pain and they are looking for a solution. The purpose of this discussion is to help provide a better understanding of plantar fasciitis, and to provide some useful information for relieving the pain associated with this debilitating condition.

How the Plantar Fascia Works

The plantar fascia is a thick, sinewy band of tissue (aponeurosis) that extends from the heel bone (calcaneus) to the balls of the feet (metatarsal heads) , and on to the toes. Since it attaches from bone-to-bone, the plantar fascia is similar to a ligament, but it has elasticity, allowing it to stretch and contract.

The plantar fascia plays a critical role in our foot's ability to absorb shock and propel itself with each step we take. Like a very thick rubber band, it stretches as our foot strikes the ground, thus allowing our arches to collapse slightly and absorb shock. As we toe-off the plantar fascia contracts, which assists our foot to propel itself forward into our next step.

When the plantar fascia becomes over-stretched, it can start to tear away from it's insertion point in the heel bone. The band of tissue becomes inflamed, triggering sharp pain in the heel and soreness across the arch. Once the plantar fascia is injured, your foot's ability to absorb shock and propel itself forward is compromised. This is a grossly over-simplistic explanation of plantar fasciitis, but it gives you an idea of how the plantar fascia works, and how it can become injured. For more in-depth information, I recommend reading Dr. Stephen Pribut's page on plantar fasciitis.

How did I get Plantar Fasciitis?

First of all, your heel pain may not be plantar fasciitis. There are a few other ailments with similar symptoms. A simple, relatively painless examination by a podiatrist will confirm your plantar fasciitis diagnosis, and rule out any other causes of heel pain, such as stress fractures. Click here for a listing of podiatrists we have heard great things about in Austin. If you don't live in Central Texas, do your homework and find a podiatrist with excellent reviews in your community.

Plantar fasciitis is usually caused by repetitive stress. We are not designed to walk on concrete all day long. The human foot is meant to walk barefoot on grass, sand and uneven surfaces. Instead, many of us spend much of our day walking on concrete, tile and hard surfaces. There is no forgiveness or variation to these surfaces, so our feet take a pounding. The plantar fascia works harder to absorb shock on concrete, becomes over stretched, and becomes inflamed as it strains to pull away from the heel bone. Excess weight and unsupportive shoes can also place additional stress on the plantar fascia. "Weekend warriors" often develop plantar fasciitis when they take up new activities, such as running, without training properly. Plantar fasciitis can also be caused by trauma, such as a sudden fall.

Will my plantar fasciitis ever heal?

Patience is critical to helping plantar fasciitis heal. The plantar fascia is a fibrous band of tissue with a limited blood supply. Blood supply is essential to healing. The plantar fascia ligament (aponeurosis), once injured, can take months to heal. The key is to take care of yourself, follow your physician's advice, and remove as many obstacles as possible to the healing process. A podiatrist or physician may recommend padding, foot manipulation, taping, orthotics, and anti-inflammatory medications to help reduce inflammation and to help accelerate healing.

The right shoe, coupled with the right arch support and cushioning can also go a long way toward reducing or eliminating heel pain.

Z-CoiL shoes can be amazingly effective at reducing heel pain and is among our top shoe picks for heel pain reduction. It never ceases to amaze me how effective these shoes can be for nagging, chronic and severe heel pain. Don't let the odd-looking appearance of the shoe fool you - Z-CoiL is a beautiful design for plantar fasciitis and heel pain relief.

Do you remember how the plantar fascia functions to both absorb shock and propel the foot forward? When the plantar fascia becomes injured, it's ability to function properly is limited. The rigid steel coil in Z-CoiL shoes absorbs 50 percent of the impact our bodies must absorb at heel strike, while returning nearly the same amount of energy as the foot rolls forward through the gait cycle. The coil essentially does the work of the plantar fascia, thus offloading much of the stress on the injured band of tissue. A rigid fiberglass-reinforced nylon orthotic cradles and supports the plantar ligaments, and a forefoot rocker ensures a smooth, rolling transition as you toe-off. The orthotic can be heated with a hair dryer and shaped for maximum comfort and support. Z-CoiL shoes also work quite well with over-the-counter arch support products, including Lynco orthotics, Superfeet, Powerstep and Spenco arch supports. There are 2 common misconceptions about Z-CoiL shoes:

1. The shoes look unstable. I believe we tend to think of "Slinky" toys when we look at a spring. A slinky is a cylindrical coil. It has to move side-to-side. The Z-CoiL spring is conical. A conical coil collapses inside of itself. If you take a slight mis-step, the Z-CoiL spring will act to level your foot and move straight down. Z-CoiL shoes are remarkably stable when you walk in them.
2. Z-CoiL shoes look like "high-heeled sneakers". Another optical illusion. Most of your height is actually in the forefoot rocker-sole cushioning. When you stand in Z-CoiL shoes, the coil compresses slightly, and the wearer will feel absolutely level in their stance. If the wearer feels "pitched forward" or "pitched back", the coil can be adjusted. There are also 4 different strengths of coils, depending on the weight and gait characteristics of the individual.

Ryn shoes are rocker-sole shoes with excellent medial/lateral stability. Unlike many of the other heel-to-toe rocker sole shoes (MBT, Skechers) the Ryn shoes tend to move straight ahead, instead of rolling in and out. They also have plenty of depth to accept orthotics, if needed. With the Ryn design, the heel and the ball of the foot don't come in contact with the ground. The force of striking the ground is absorbed by a structured air tunnel system that reduces the impact forces on the foot and promotes a smooth, rolling gait. Since Ryn shoes have exceptional side-to-side stability, the foot resists over-pronating (rolling inwards) which can place additional stress on the plantar fascia. We have also seen many customers that have reported significant heel pain relief wearing Ryn shoes.



Aetrex, Brooks, Somnio are fine examples of companies that make make shoes that can be customized for the needs of the individual wearer. High-arched feet travel differently than low-arched feet. Each of these companies make shoes that address the shape, structure and support needs of our feet. Selecting the right shoe, coupled with the right support can make a huge difference in reducing heel and foot pain. Aetrex uses their patented iStep technology to digitally scan feet, identify areas of peak pressure, and recommends the proper shoe and arch support. Somnio shoes can be customized with variable heel and forefoot cushioning, arch support and pronation control inserts. Brooks makes excellent shoes for walking and running. Each of these companies has devoted exhaustive research into engineering shoes and support for the casual walker or serious runner, and we have seen excellent results fitting these shoes.

Finally, never go barefoot in your house when you have plantar fasciitis. Wear a good, supportive house shoe when you get out of bed. There are many products that fall into this category, but Fitflop, Alegria, Spenco Total Support and Finn Comfort sandals have worked very well with our customers suffering from heel pain.

This has been a very brief introduction to helping better understand plantar fasciitis and heel pain. There is much more that has be written about this subject, but hopefully this serves as a good starting point. According to Dr. Pribut and several other references I have researched, over 98 percent of plantar fasciitis cases can be successfully treated without surgery. Take care of your feet, listen to your doctor and wear the right shoes.

Finally, here's a very informative video that helps provide a better overview of plantar fasciitis along with conservative, non-surgical treatment options:





To your health,

Cam White, CFts
Total Relief Footwear
Austin, TX