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Note: If you have heel pain with redness or warmth in the heel, or fever, or numbness or tingling in any part of the foot, see your doctor. Do not self-diagnose plantar fasciitis: the symptoms could have other causes. 

The plantar fascia is the largest ligament in the body. It connects the heel to the toes: if the arch of your foot was a bow, the plantar fascia would be the string. 

When that ligament is chronically inflamed or begins to deteriorate, the result is plantar fasciitis. This condition most often manifests as a sharp pain on the bottom of the heel, though pain may occur on the bottom of the arch of the foot or almost anywhere on the bottom of the foot. Pain in the bottom of the feet immediately after getting out of bed is a common sign of plantar fasciitis.

Plantar fasciitis is often caused by excessive running or walking, especially on hard surfaces and in shoes not designed to provide proper arch support. High body weight, very high arches, and chronically tight calf muscles may aggravate or contribute to the problem.

Plantar fasciitis should be diagnosed by a doctor. Your doctor may order scans to rule out other possible causes of your symptoms. 

Your immediate task once it’s been confirmed that you’re suffering from plantar fasciitis is alleviating the worst of the symptoms. Your doctor may prescribe medication and exercises or refer you to a physical therapist. Some doctors may inject corticosteroids directly into the ligament, which can provide immediate relief but cannot be repeated at frequent intervals.

In the long run, you’ll be back to those familiar needs: regular stretching and strength training to build up the surrounding muscles. Your doctor may recommend that you lose weight and avoid impact on hard surfaces while you recover. Some cases of plantar fasciitis may be relieved by orthotics, which are shoe inserts that provide support to specific parts of the sole or arch.

If plantar fasciitis pain is severe, you may have to take a brief break from hiking while you recover. During that break, you’ll want to stretch regularly and look for specific stretching exercises that relieve your pain. 

A physical therapist can recommend specific stretching exercises and muscle building exercises. Some hikers find that rolling the foot over a pin-shaped roller or even rolling a bare foot over a frozen golf ball provides relief. Some patients find that massage gives some relief. Use massage and stretching to relax your calf muscles and see if you feel improvement.

Many plantar fasciitis patients find that shoe selection is a key part of getting back to hiking without excessive discomfort. Ask a podiatrist about orthotics and about specific areas where your feet may need support. Some large outdoor retailers, notably REI, have sales staff that are trained to help customers with foot problems select appropriate shoes. That assistance can be worth some travel time.

On the trail, you may find that occasional rest, elevation, and periodically soaking bare feet in cold water, if available, can alleviate symptoms. You may want to carry pain relievers as a backup if the pain becomes severe, though it’s rarely a good idea to use them frequently or continuously.

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