Tearing of the plantar fascia can be caused by:
- Improper footwear
- Increased activity level
- Walking on uneven surfaces
- Trama to the foot
Pain occurs because of micro tearing in the fascia tissue. When the fascia is not in use or is properly supported by an orthotic, the tears begin to heal. However, when the fascia is unsupported and active weight bearing begins, there is constant tearing causing exquisite pain. This same type of tearing and pain can be compared to a paper cut or scraped knee trying to heal – bend your knee and the scab re-opens causing pain.
The attachment site of the plantar fascia band on the calcaneous (heel bone) has the constant force being placed repeatedly on the heel bone with every step. If the fascia band is weakened or torn, each step you take can further injure the band. Because you are always on your feet, the tissue doesn’t get a chance to rest long term to heal, so it stays injured.
Over time, the heel bone responds by developing a spur like shape at the end of the calcaneous and grows forward into the damaged fascia band.
The spur then spans the injured area and decreases the distance the fascia has to stretch. This growth or heel spur is the body’s attempt to heal the injury, so the heel spur itself is seldom the problem and it usually is not painful.