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Todd Borenstein MD

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Plantar Fasciitis

What is plantar fasciitis?

The plantar fascia is a thick band of connective tissue extending from the heel to the ball of the foot. It is one of the structures that supports the arch of the foot. Microscopic tearing of the plantar fascia can occur leading to inflammation and pain in the heel. This painful condition is called plantar fasciitis. Plantar fasciitis is the most common cause of heel pain.

What causes plantar fasciitis?

Risk factors for plantar fasciitis include excessive standing, increased body weight or obesity, increasing age, calf tightness, starting new activities and increasing activity, wearing improper shoes, feet with high or low arches.

What are the symptoms of plantar fasciitis?

Patients with plantar fasciitis often describe heel pain first thing in the morning when they get out of bed. There is also often pain associated with activity after sitting for a period of time. The pain is located in the heel and is often described as sharp, stabbing or burning in nature. It may improve with moving, walking or stretching.

How is plantar fasciitis diagnosed?

Plantar fasciitis is diagnosed with a thorough medical history and physical examination to localize the pain and identify any exacerbating factors. X-rays may be ordered to assess for a bone spur, stress fracture, or soft tissue calcifications.

How is plantar fasciitis treated?


Nonsurgical management of plantar fasciitis has excellent results with the majority of patients, roughly 90%, having their symptoms resolve. The mainstay of nonsurgical management includes daily calf stretching and plantar fascia specific stretching. Other helpful treatments include rest, physical therapy, custom and non-custom orthotics, anti-inflammatory pain medications, weight loss, cortisone injections, night splints and extra-corporeal shock wave therapy.


Surgical intervention is considered for patients with painful plantar fasciitis after failed treatment for a minimum of 6-9 months. Surgery may include surgical lengthening of the calf muscle to decrease the force on the plantar fascia and endoscopic plantar fascia release.