Doctors usually diagnose
plantar fasciitis based on a medical history and a
physical exam. Your doctor will check your feet for problems that affect how
your feet work (biomechanical factors), such as a high arch, flat feet,
abnormal gait, or tight
Achilles tendon or calf muscles. Your doctor will also
look for excessive tenderness and examine joint motion and looseness, muscle
and tendon function, nerve function, and blood circulation.
Why It Is Done
Your doctor will do a physical exam
to evaluate heel pain.
Findings of a physical exam may include the
In a normal exam there is no pain, tenderness, or
swelling in the heel area. Structure, function, and biomechanics are normal as
Abnormal findings that may point to plantar fasciitis
include the following:
You have pain when you take your first steps
after getting out of bed or after sitting for a long period of time. Your
doctor usually will learn this during a review of your medical history.
When your doctor presses your heel, you have a tender spot deep in the tissue on the bottom of your heel where the plantar
fascia attaches to the heel bone just in front of the heel
Sometimes there is tenderness in the middle of the plantar
ligament or elsewhere in the plantar ligament. This pain is more common in
athletes who spend a lot of time on the balls of their feet, as in aerobics,
sprinting, basketball, or cycling.
Flexing or standing on your toes
causes heel pain.
Local swelling in the bottom of the foot may be
present, which may mean there is more significant tearing in the plantar
When you stand, you have a high or low arch. When you walk,
you have excessive inward rolling of the foot (pronation) when your heel
strikes the ground.
Visible inflammation is usually not present.
What To Think About
Your doctor usually will start
nonsurgical treatment without further testing. X-rays and lab tests usually are
not needed if the medical history and physical exam point to plantar
fasciitis and your doctor does not suspect other problems.