GREENVILLE, SC (WSPA) – Plantar fasciitis is the most common cause of pain on the bottom of the heel, according to the American Academy of Orthopaedic Surgeons.

Bon Secours St. Francis Orthopedic surgeon Jay Womack said people with the condition typically have a tight Achilles’ tendon. He said it results in heel pain that people feel on the bottom or inside of their instep and is usually related to an increase in physical activity or working in jobs that require standing over long periods of time.

Symptoms include stabbing pain in the foot, usually in the morning. Dr. Womack explained that the reason is, “during sleep, people tend to flex their feet forward.“

He said the condition happens when a tendon on the bottom of the foot tears where it connects with the bone on the heel.

“I often find that people are smart and they realize stretching helps but they don’t do it enough,” he said. “If you come in to see me, we give you a stretching program, which I really ask you to diligently commit to 4 or 5 times a day for a minute.”

Dr. Womack said the success rate with dilligent stretching is 90 percent.

“It’s that 10 percent of people that don’t improve, that at about that 4 to 6 month mark, we start talking about surgery.”

For relief, Dr. Womack also advises against cortizone shots.

“It carries risks to do multiple injections in the heel,” he said. According to the American Academy of Orthopaedic Surgeons, those risks include rupturing of the plantar fascia, which can lead to a flat foot and chronic pain.

However, he did recommend wearing night splints, which he says will stretch the plantar fascia tendons during sleep.

“It really does work,” he said. “It has such good science behind it that insurance companies actually cover a night splint.”

For people with plantar fasciitis, the American Academy of Orthopaedic Surgeons recommends calf stretches against a wall and the plantar fascia stretch, which is done from a seated position. Here are some instructions from the AAOS:

  • Calf stretch 
    Lean forward against a wall with one knee straight and the heel on the ground. Place the other leg in front, with the knee bent. To stretch the calf muscles and the heel cord, push your hips toward the wall in a controlled fashion. Hold the position for 10 seconds and relax. Repeat this exercise 20 times for each foot. A strong pull in the calf should be felt during the stretch.
  • Plantar fascia stretch 
    This stretch is performed in the seated position. Cross your affected foot over the knee of your other leg. Grasp the toes of your painful foot and slowly pull them toward you in a controlled fashion. If it is difficult to reach your foot, wrap a towel around your big toe to help pull your toes toward you. Place your other hand along the plantar fascia. The fascia should feel like a tight band along the bottom of your foot when stretched. Hold the stretch for 10 seconds. Repeat it 20 times for each foot. This exercise is best done in the morning before standing or walking.

According to the AAOS, risk factors for plantar fasciitis include high foot arches, obesity, tighter calf muscles that make it difficult to flex your foot and bring your toes up toward your shin, repetitive impact activity such as running, and new or increased physical activity.

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