Your feet may be key to helping you power through your day, from a morning workout to grocery shopping to standing in your boss’s office for a meeting that just won’t end. So when the bottom of your feet hurt it can really throw your life out of whack. Forget about going for a walk or run; sometimes, it hurts to even take that first step on the floor when you wake up in the morning.

The most common cause of bottom of the foot pain is plantar fasciitis. It happens when the plantar fascia — a band of tissue that runs along the bottom of your foot and supports your foot arch — becomes inflamed, says Courteney Kemp, PT, DPT, a physical therapist at Hinge Health. Plantar fasciitis is very common. About one in 10 people will experience it at least once in their lives, and about two million people in the United States see their doctor for this condition each year. 

While plantar fasciitis can definitely be painful, most people respond quickly to simple treatments such as gentle foot and ankle stretching and strengthening exercises, reassures Dr. Kemp. As one Hinge Health member shared, after doing exercise therapy for a few weeks, “my plantar fasciitis is much better now. My foot is no longer swelling, and I can now fit in shoes I couldn’t wear.”

Here, learn more about what causes plantar fasciitis and get tips and exercises from our physical therapists to help ease your foot pain.

Plantar Fasciitis Symptoms 

Here are some clues that your foot pain could be due to plantar fasciitis:

• Sharp bottom of foot pain near your heel. “It’s right where the plantar fascia inserts, where the heel meets the arch,” says Dr. Kemp. 

• Pain with the first few steps after you get out of bed in the morning, or after a long period of sitting. The pain often improves after a few minutes of walking as the tissue stretches out.

• Pain during and after exercise.

• Pain after being on your feet for long periods of time.

Plantar Fasciitis Causes

Your plantar fascia is a strong, thick, tendon-like structure that runs along the arch (bottom side) of your foot from your toes to your heel. It helps absorb the stress of daily life, whether you’re walking to work or playing a high-impact tennis game. Normally, your feet can handle a lot of stress from a variety of activities. Sometimes, though, it’s a little too much and you experience pain. “Your body’s natural response to try to heal this is to create inflammation. That, in turn, causes the heel pain and stiffness of plantar fasciitis,” says Dr. Kemp.  

Plantar fasciitis can happen to anyone. But some of the more common triggers include:

• Increase or change in load. Any activity that puts extra stress on your heels can contribute to plantar fasciitis. That’s why it tends to be common among runners and walkers, says Dr. Kemp. But that doesn’t mean walking or running is bad for your feet, and being sedentary is not the solution. Rather, if you are prone to plantar fasciitis, it just means you need to show your feet some extra TLC. (More on this below.)

• Doing a new activity your body isn’t accustomed to. This could be something like standing on a hard surface for a long time if that’s not something you typically do. “This can contribute to strain on the arch of your foot,” explains Dr. Kemp. That’s one reason plantar fasciitis appears to be more common among people who have professions like nurses, factory workers, and teachers.

• Anatomy. Flat feet or high arches can add some stress on your plantar fascia. “If you have a high arch, there’s more strain on your fascia,” says Dr. Kemp. “If you have flat feet, the plantar fascia can stretch more, but there’s also more pressure on it if you push off as you walk or run.” Having flat feet and high arches don’t usually create a problem for everyday activities. “We see this more when people ramp up their walking or running regimen quickly, which can irritate the plantar fascia a bit,” she notes.

• Tight lower leg muscles. Tight calf muscles can affect the bottom of your feet. “When your calves are tight, the strain can also impact where your calf muscles attach to your heel bone,” Dr. Kemp explains.

• Age. Plantar fasciitis is most common among people between the ages of 40 and 60, according to the American Academy of Orthopedic Surgeons. A study from the Foot & Ankle Surgery journal also found that people over age 45 were more likely to have a thicker plantar fascia than younger folks.  

A Word from Hinge Health About Plantar Fasciitis

It can be upsetting to read a long list of contributors to a condition where you feel like there’s not much you can control. You’re not likely going to change professions, after all; there’s nothing you can do about the shape of your feet. We get it. We include the above plantar fasciitis causes to help you learn about possible contributing factors, but they are not the final word. Every day, our Hinge Health physical therapists work with people who have foot pain to provide exercises, activity modifications, and lifestyle tips to ease pain and make things easier. No matter what might be contributing to your plantar fasciitis, there is a lot you can control to ease your pain and start feeling better.

How to Treat Plantar Fasciitis

The vast majority of people with plantar fasciitis feel better with simple treatment methods. Here are some ways to handle bottom of foot pain:

Modify your activities. You should absolutely continue to be active, move, and exercise, stresses Dr. Kemp. If you are sedentary, your plantar fascia will just tighten up more. If certain activities hurt, find a gentler alternative. For example, if you’re a runner and it hurts the bottom of your feet to run, consider switching to brisk walking or cycling temporarily. These activities are also a great way to stretch your calf muscles, which helps keep your plantar fascia healthy.

Stretch first thing in the morning. Stretch out your plantar fascia when you wake up in the morning or after you have been sitting for a long time, says Dr. Kemp. You could even roll your foot over a frozen water bottle for five to 10 minutes. “The bottle provides a massage to loosen up tight tissue, and the ice helps to decrease pain and inflammation,” she explains.

Take over-the-counter medications as needed. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can be helpful for bottom of foot pain. It’s important to make sure that you are safely able to take these medications, based on your medical history.

Do physical therapy. A physical therapist can create an exercise program to help you stretch and strengthen your calf muscles and plantar fascia. You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.

Wear silicone heel pads. These raise and cushion your heels. You can find them at your local drugstore or at big-box retailers like Amazon. They may help relieve pain, especially if used along with frequent stretching.

Use athletic taping. This has been shown to improve symptoms of plantar fasciitis because it provides more support to your foot arch. A PT can show you how to apply tape to support the bottom of your feet, says Dr. Kemp.

Night splints. If your pain persists even with all the above measures, you may want to consider a night splint, says Dr. Kemp. These stretch out your plantar fascia as you sleep. They can be very effective for some people, but since they can be hard to get used to, they’re not usually recommended right away.

Can You Prevent Plantar Fasciitis?

If you’ve had plantar fasciitis once, you don’t want to have it again. Here are some tips to help prevent bottom of foot pain flares from recurring:

• Stay active. This helps keep your feet, as well as your hips and lower legs, strong. It also helps keep your body resilient to pain flares. Be sure to increase the frequency and intensity of your exercise gradually to help your body adjust and stave off pain. 

• Wear supportive shoes. Strappy sandals are fine for an hour or two, but in general, everyday shoes should be sturdy, well-cushioned, and have good arch support. You can also pop in an over-the-counter heel pad for extra support. 

• Change out your athletic shoes more frequently. The American Academy of Podiatric Sports Medicine recommends replacing shoes every 300-500 miles of running or walking, and every 45-60 hours of activities like basketball, aerobic dance, or tennis. (That’s roughly a new pair of shoes every year if you do these activities an hour a week.)

• Consider orthotics. If you have flat feet or high arches, orthotics can help foot arch pain, which can reduce the risk of plantar fasciitis, says Dr. Kemp. A 2018 study published in the British Journal of Sports Medicine found that naval recruits who used an OTC foot orthotic were less likely to experience foot injuries, including plantar fasciitis.

• Cross train. This just means incorporating a variety of activity types into your routine. So if you normally do activities that involve running or jumping every day of the week, try mixing in some biking, swimming, stretching, and strengthening exercises a few days in place of your normal activities. This gives you a chance to work a lot of different muscles and helps your body build up strength, tolerance, and resilience to activities that tend to cause you foot pain. 

When to See a Doctor

Plantar fasciitis symptoms usually heal on their own with time, although doing the stretches and exercises below will help. If your pain persists or gets worse after a few weeks, you may want to see a podiatrist, orthopedist, or physical therapist. They can help determine whether your symptoms are due to plantar fasciitis or another issue like a stress fracture or a bone spur.

PT Tip: Focus on Building Up Your Tolerance

It’s important to remember that there’s no such thing as a “bad” activity, even if you have plantar fasciitis and certain activities cause some pain. “It's all about building up your tolerance to activity,” says Dr. Kemp. For example, if you're a runner or an avid walker and those activities hurt your foot, start with short walks or runs and do them more frequently throughout your day or week, Dr. Kemp suggests. Then, gradually increase the duration or intensity of your workouts. This allows the tissue to build up tolerance and be able to handle more stress placed on it. 

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program. 

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.  

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you. 

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

1. Trojian, T., & Tucker, A. K. (2019). Plantar Fasciitis. American Family Physician, 99(12), 744–750. 

2. Buchbinder, R. (2022, November). Plantar Fasciitis. UptoDate. https://www.uptodate.com/contents/plantar-fasciitis

3. Perri, M. J., Beahrs, T., & Kadakia, A. R. (2022, August). Plantar Fasciitis and Bone Spurs. American Academy of Orthopedic Surgeons. https://orthoinfo.aaos.org/en/diseases--conditions/plantar-fasciitis-and-bone-spurs 

4. Furman, A. (n.d.). How Do I Know When It Is Time To Replace My Athletic Shoes? American Academy of Podiatric Sports Medicine. http://www.aapsm.org/replace_shoes.html

5. Bonanno, D. R., Murley, G. S., Munteanu, S. E., Landorf, K. B., & Menz, H. B. (2017). Effectiveness of foot orthoses for the prevention of lower limb overuse injuries in naval recruits: a randomised controlled trial. British Journal of Sports Medicine, 52(5), 298–302. doi:10.1136/bjsports-2017-098273