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Plantar Fasciitis, Neuromas, and Orthotics

Plantar Fasciitis

What is plantar fasciitis?

The most common cause of heel pain is Plantar Fasciitis. The planter fascia is the flat band of tissue (ligament) that connects your heel bone to your toes and supports the arch of your foot. Straining of the planter fascia can make it weak, can cause swelling, and can cause inflammation. This can then cause your discomfort to your heel or bottom of your foot when walking or even standing. Plantar Fasciitis is common in middle aged people, but also occurs in younger people who are on their feet a lot like athletes, soldiers, or even bartenders. This can afflict either both feet or just one foot.

What are the symptoms?

For the vast majority of people the first symptoms are in the morning when you take you first steps after getting out of bed. It can also occur after sitting for long periods of time. You may feel less pain and stiffness after you take a few steps, but the pain in your foot might increase as the day wares on. It usually hurts the most after standing for prolonged periods of time or when climbing stairs.

What causes plantar fasciitis?

Plantar fasciitis is caused by straining the ligament that supports your arch. Repeated strain can cause tiny tears in the ligament which can lead to pain and swelling. This is more likely to happen if:

  • Your feet roll inward too much when you walk (excessive pronation).
  • You have high arches or flat feet.
  • You walk, stand, or run for long periods of time, especially on hard surfaces.
  • You are overweight.
  • You wear shoes that don’t fit well or are worn out.
  • You have tight Achilles tendons or calf muscles.


People who suffer from neuromas endure sharp pain and numbness in their forefoot and toes. Referred to normally as Morton’s Neuroma (named after the doctor who first diagnosed that particular condition) is best described as a noncancerous mass of nerve tissue that has been agitated by metatarsal bones rubbing together. The movement that occurs in the bones pinches certain nerves causing inflammation, which then is the primary cause of the neuroma forming.


When your foot is affected by neuroma, it cannot withstand the pounding of jogging, running, or jumping. All high impact activities should be crossed off of your to do list straight away until your foot has completely recovered. Going to your doctor and getting them to test your full range of motion and gauge the strength can help you figure out how far along you are in your recovery. All of your workouts should be modified to either low impact or no impact activities such as swimming or biking until there is no more pain or limping while you walk.

Exercises to Help Recovery

As you begin the recovery process, there are a few exercises that can help to alleviate some of the foot pain and discomfort. These exercises will be able to strengthen the supporting muscles in the foot and ankle and increase the space between the metatarsal bones to help provide more comfort. Try to support yourself and use a bottom step to help exercise your foot. By placing your forefeet on the step and letting your heels hang out loose and free. Then proceed to raise your toes and then bring your heels below the step performing a deep stretch.

This second stretch can be performed against a countertop or wall. While standing about two to three feet from the counter or wall, whichever you chose to use, lean forward and use your hands to brace yourself. While doing this slowly start bending your right knee and lift your heel from the ground. Repeat this motion on the left side and then continue to keep repeating it until you feel an ease in the forefoot tightness.

Lastly this final exercise is done while being seated using a sturdy chair with a tall straight back. Begin to extend one leg and then lift it until the leg is not touching the seat anymore. Flex your foot and start swirling it in a circular motion. Repeat this process on the other foot. If at any point any of these exercises cause you the even the slightest amount of pain, stop immediately! The goal of these exercises is to purely relieve that tightness you feel in your foot and to relax it.


Orthotics are orthopedic devices that are used to alter or modify foot function and are designed to treat, adjust, and support various biomechanical foot disorders. Certain orthotics are very simple commercially made devices like insoles or cushioned heel cups for shoes that are sold in drug stores over the counter or in any other retail stores.

However, some of the most effective orthotics are custom made devices that are crafted with the sole purpose of helping particular individuals. A mold of the foot is taken and the custom orthotic is made from a cast of the impression. This will then duplicate any misalignments in the foot’s structure. Using this molding and computer technology allows technicians in an orthotic laboratory to design a device that corrects misalignments and balances out deformities.

The final product of this finished orthotic device is placed in the patient’s shoe to support the foot and eliminate any abnormal foot biomechanics by keeping the foot properly aligned at all times. Depending on the individual patient’s needs, the orthotic may have padded cushioning for the foot to make it more comfortable.

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