The clinician will press the toes back with one hand, to make the fascia taut, and try to elicit pain with the thumb of the other hand. Sometimes magnetic resonance imaging (MRI) is ordered to rule out other possible causes of heel pain, such as a stress fracture.
She or he will examine your foot and confirm the diagnosis by eliciting pain while pressing on a specific area of your heel (see illustration) or when flexing your foot upward, which stretches the fascia. Your clinician will ask you to describe the symptoms and say when they started and what makes them worse. It's more common in people who are obese or flat-footed and also in older people, because the plantar fascia loses its elasticity with age, making it more vulnerable to injury.
Plantar fasciitis results mainly from high-impact activities, such as running and jumping, but it can also occur after prolonged periods of standing. When pressure or strain damage or overstretch the plantar fascia, swelling, tearing, or bruising can occur. The cause of the pain is inflammation of the plantar fascia, a band of tendon-like tissue that extends along the bottom of the foot (the plantar surface) from the heel bone to the ball of the foot, where it fans out to attach to the toe bones. The pain may go away as you walk around, but it's likely to return at the end of the day if you spend a considerable part of it on your feet. It's usually at its worst first thing in the morning and when you get up after sitting for a long time. The main symptom is intense pain that feels like a deep bruise on the bottom of the foot, just in front of the heel.
Getting out of bed in the morning marks the beginning of a new day, but it can be an excruciating start for people with plantar fasciitis, one of the most common causes of heel pain in adults. To relieve heel pain, simple therapies may be all you need.
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