Plantar Fasciitis: A Look At The Underlying Causes

Plantar Fasciitis is generally characterized as sharp, stabbing pains in the bottom (plantar surface) of the foot. The location of the pain may vary from person to person, with some people feeling the pain located directly under their heel, while others feel the pain more in the arch of the foot. For most individuals, this pain is greatest upon waking, followed by a slight decrease in pain throughout the middle of the day, and then another spike as the end of the day nears.

The Anatomy Behind Plantar Fasciitis

The key muscular players in planter fasciitis are the gastrocnemius and soleus muscles along the back of the lower leg (commonly referred to as the calf muscles), as well as possible tibialis anterior and/or the peroneus muscles involvement.

Due to overuse, the muscles will pull on the plantar fascia, which is a sheet of fascia that goes along the bottom of your foot. This fascia attaches to the medial process of the calcaneal tuberosity (heel bone) at the back of your foot, and then at the front it attaches to the plantar surface of the matatarsophalangeal joints as well as the flexor tendon sheaths.

The best way to envision the function of the plantar fascia is to imagine that your foot is a bow. The bones of foot make up the bow with its curve, and then the plantar fascia acts as a bow string. This allows the arch of your foot to absorb stress and pull back into its curved shape when not under pressure. One possible side effect of how the "bowstring" (plantar fascia) connects to the surrounding tissues, is that you can develop a bone spur if the plantar fascia remains stressed for an extended period of time.

When the bone spur develops, it is due to the plantar fascia pulling on the periosteum (outer lining) of the calcaneus bone. When the periosteum is being pulled, your body tries to reinforce the area by filling in the pulled area with more bone. On a positive note, however, this can be reversed by removing the tension in the plantar fascia.

Other Causes of Heel Pain That Should Be Ruled Out

-Stress Fracture: a stress fracture in the calcaneus bone can cause a similar stabbing sensation in the heel. When pressed from both sides of the outer portions of the calcaneus, a stress fracture will be painful. If this is a symptom that you are experiencing, you should consult with a physician to see if x-rays are necessary.

-Contusion: it is possible to bruise the bottom of your foot. This would normally be caused by some blunt force trauma, but can also be due to overuse, weight gain, or poor footwear. Depending upon how deep the contusion is, it may not be visible on the surface of the skin.

-Tarsal Tunnel Syndrome: Similar to carpal tunnel syndrome, tarsal tunnel syndrome is due to nerve entrapment. A Tinel's Sign test may be preformed by directly tapping on the posterior tibial nerve. A positive test would present with neuropathy that causes local and traveling tingling or a sharp shooting pain.

Corinne D. Bracko-Douglas, CMT, LMT, CKTP is the owner of Dochas Clinical Massage Therapy based out of Columbia, MO. She received her diploma in Clinical Massage Therapy from The Soma Institute in Chicago, IL in 2004. She enjoys teaching others about how to live a healthy lifestyle and still works one on one with clients out of her private clinic. When not working as a therapist she can be found enjoying trail hikes with her wonderful husband, Lee, and their adorable doggos, Shadow and Koda, or trying out fun new workouts to expand her knowledge of the human body and how it functions.

The advice given in these articles is not meant to diagnose. Please always consult with a health care provider before performing any of the techniques described upon yourself.


  1. This comment has been removed by the author.

  2. Will get my plantar fasciitis insoles in Singapore. I've been suffering for so long and started my treatment last month.


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