You get out of bed in the morning or stand up after a long stretch of focusing at your desk. When your foot hits the floor, a sharp sensation shoots up the bottom of your heel, almost as if you’ve stepped on a nail, or like a pebble’s worked its way into your shoe.
Sound familiar? Chances are, you have a condition called plantar fasciitis, which occurs when the thick band of tissue that connects your heel to your toes becomes inflamed, Alyssa Carroll, DPM, a sports podiatrist in Raleigh, North Carolina, tells SELF. It’s painful, annoying—and actually pretty common. Plantar fasciitis affects more than two million people in the US yearly. Leada Malek, DPT, CSCS, a spokesperson for the American Physical Therapy Association, tells SELF she typically sees at least two patients weekly who are coping with it.
Heel pain (and the accompanying aches that can come with it) can interfere with your workout routine and your everyday life, even making walking painful and causing you to alter your gait in ways that can lead to other problems. Here’s more about why it happens—and how to get some relief for your feet.
What causes plantar fasciitis, and who’s at risk?
The plantar fascia plays a key role in propelling your foot forward as you walk. When you step down and put weight through your heel, your toes begin pointing upward, tightening the tough band of tissue. This response—known as the windlass mechanism—supports your arch as you stride, so you can roll through to the next step.
But this design, while elegant, isn’t foolproof: “By nature, it’s pulling on the insertion point,” or where the ligament-like tissue connects to the heel bone, Dr. Malek says. “That tensile load can surpass its capacity.” The overstressed tissue, either along your arch or right next to your heel, can then sustain tiny tears and become irritated, inflamed, and painful.
Sometimes, foot anatomy plays a role in overloading the plantar fascia and causing inflammation and pain, Dr. Carroll says. Flat feet often contribute to overpronation, when your foot rolls farther inward with every stride, adding extra tension. Meanwhile, high arches can lead to underpronation—when your foot rolls outward—adding strain from the other direction.
Tight calves can also pull on your Achilles, which then tugs on your plantar fascia, since both attach to your heel bone. “It’s kind of this lever system; if one’s tight, the other is also tight,” Dr. Carroll says.
High-impact sports, like running or HIIT classes, can irritate the plantar fascia, especially if you ramp up quickly without giving your body time to adapt to the pounding. “It’s usually too much, too soon, too fast,” Leah Avery, DPT, PT, a physical therapist and running coach in Bentonville, Arkansas, tells SELF. For example, your risk increases if you start running and immediately go from zero to five days a week.
Running, walking, or hiking on an incline can also add extra strain, as can beach volleyball or other activities performed on sinking or uneven surfaces. Combining any of these factors with a job that keeps you on your feet all day, especially on a hard surface, may cause plantar fasciitis to develop or worsen more quickly, Dr. Avery says.
What are the signs and symptoms of plantar fasciitis?
Post-static dyskinesia—the official term for that stabbiness upon taking your first few steps—is a hallmark sign of plantar fasciitis. When you’re sitting or sleeping, the plantar fascia tightens. Then, “when you go to stand back up, on a microscopic level, everything is kind of ripping back open,” Dr. Carroll says.