Your Personal PT, Rachel Tavel, is a Doctor of Physical Therapy (DPT) and Certified Strength and Conditioning Specialist (CSCS), so she knows how to get your body back on track when it’s out of line. In this weekly series, she gives you tips on how to feel better, get stronger, and train smarter.

When every step is painful, you’re going to look down to figure out what’s up.

Heel pain can be extremely uncomfortable. You might feel like a sharp object is poking into the heel of your foot while you’re walking, or even a constant dull, stiff, and tight ache. Either way, if you don’t get rid of the pain quickly, it may limit the amount of time you spend on your feet.

One common cause of heel pain is plantar fasciitis. Plantar fasciitis is an inflammation of the proximal attachment of the plantar fascia—a broad band of tissue that extends from the heel of your foot (the calcaneus) to the row of metatarsal bones just before your toes. This band of fascia tightens when you plantarflex or point/stand/push off on your toes, creating a rigid lever through a biomechanical model called the windlass mechanism. This softens when the feet are flat, supporting the structures in the foot but allowing more mobility between the joints.

According to research, 1 in 10 people are affected by plantar fasciitis. If you fall into this category, you are definitely not alone. While you may feel pain in the foot, plantar fasciitis is often due to other problems such as hard, unsupportive footwear (avoid flat, hard soled shoes), tight posterior chain musculture (everything from your hamstrings to your calf muscles ultimately leading to tightness through the Achilles tendon and plantar fascia), or proximal (hip/core) weakness leading to poor body mechanics and improper loading of the foot and ankle.

Plantar fasciitis usually develops gradually, and can be common in people with relatively flat feet, poor/flat-soled footwear, or in anyone with weak or tight calves. Repeated loading of this fascia through dynamic activities such as walking or more fast-paced sports can overload the attachment point and cause pain and inflammation at the heel. Classic symptoms include pain that is worse with the first steps in the morning or when walking barefoot on a hard floor.

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