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    HEEL PAIN

    Stretching under stress

    A flattening of your arch or overuse can cause your plantar fascia to stretch and pull on your heel bone. That can result in microscopic tears in the fascia, inflammation, and a piercing pain or burning sensation.

    The pain usually develops gradually, but can come on suddenly and severely. It tends to be worse in the morning, when the fascia is stiff. Although both feet can be affected, it usually occurs in only one foot.

    The pain generally goes away once your foot limbers up. But it can recur if you stand or sit for a long time. Climbing stairs or standing on your tiptoes can also produce pain.

    In severe cases, your foot may hurt whenever you put pressure on it, making walking difficult.

    You may also develop a bone spur that forms from tension on your heel bone. In most cases, the spur doesn't cause pain.

    Common causes

    Plantar fasciitis can affect people of all ages. Factors that increase your risk include:

    Age--As you get older, your plantar fascia loses some of its elasticity and doesn't stretch as well. In addition, the fat pad covering your heel bone thins out and isn't able to absorb as much shock when you put weight on your foot. That places more stress on your heel bone and the tissues attached to it.

    Weight-bearing activities--Walking, jogging, lifting heavy objects and standing for long periods place added pressure on your feet. When performed regularly, they may stress your plantar fascia.

    Plantar fasciitis can also occur if you've been physically inactive and then plunge into a weight-bearing activity, such as playing golf or walking more than you're used to while vacationing.

    Shoes--Shoes with thin soles, poor arch support, that are too loose around your heels, lack shock absorbency, or are worn out can be harmful to your feet.

    In addition, regularly wearing high heels (greater than 2 inches) can shorten your Achilles' tendon, which attaches to your heel bone, and tighten your calf muscles. This increases the strain on your heels when you switch to a flatter shoe.

    Weight--Excess weight increases pressure on your feet.

    Poor biomechanics--A flat foot, high-arched foot, or abnormalities in your gait may prevent your weight from being evenly distributed when you walk or run. This stresses your plantar fascia.



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