Plantar fasciitis is a common source of pain under the heel (Figure 1). The etiology of the condition is thought to be overuse, with traction and shear forces applied to the plantar fascia causing microscopic injuries to the tissue. It is not a purely inflammatory condition as the “itis” suffix would suggest. Classic findings of plantar fasciitis include pain and tenderness in the heel at the junction of the plantar fascia and the medial calcaneal tuberosity. Symptoms are usually worse with the first few steps in the morning (so-called “start up pain”). Helpful treatments include stretching of the calf muscles and the plantar fascia itself and the use of orthotics with a medial arch support.
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