Understanding Ankle Pain from Plantar Fasciitis

Understanding Ankle Pain from Plantar Fasciitis

Plantar fasciitis is a common cause of heel and arch pain that can also radiate up the ankle. The repetitive strain and inflammation of the plantar fascia ligament causes symptoms like sharp stabbing or burning foot pain, especially with the first steps in the morning.

While plantar fasciitis is typically associated with pain in the heel and arch, it can also affect the ankle in some cases. Understanding where the pain originates, how it spreads, and contributing factors that lead to ankle discomfort can help guide treatment options.

What Is Plantar Fasciitis?

Plantar fasciitis refers to inflammation of the plantar fascia, a thick fibrous ligament that runs across the bottom of your foot from the base of the toes to the heel bone. This ligament helps support the arch and it flexes with every step.

When overstretched, small micro tears and inflammation can develop in the plantar fascia. The morning pain comes from the ligament tightening up overnight after walking on it all day.

With repeated strain, more severe damage and scar tissue replaces the once flexile tissue, leading to often debilitating pain and dysfunction. Heel spurs may also form with chronic plantar fasciitis cases.

How Plantar Fasciitis Leads to Ankle Pain

Plantar fasciitis causes pain predominately centered on the heel and arch areas. However, since it affects the foot’s foundational support structure, discomfort or weakness can ripple outward.

As you adjust your gait to avoid putting weight on the tender heel, additional stress transfers up the leg to the ankle. Angling the foot inward or outward rather than landing evenly can tweak ankle alignment and lead to aches.

The plantar fascia also connects with the Achilles tendon running up past the ankle. Inflammation where they attach can make that tender spot where you tie your shoes sore to the touch.

Other Causes of Heel and Ankle Discomfort

While plantar fasciitis tends to cause pain in a very specific spot on the heel, several other foot conditions lead to similar symptoms plus added ankle discomfort:

• Heel spurs: Calcium bone deposits that form on the heel bone put tension on tissue connections leading to ankle pain.

• Posterior tibial tendon dysfunction: This tendon supports the foot’s arch so damage to it shifts more strain to the ankle.

• Tarsal tunnel syndrome: Irritation of the nerve running on the inside of the ankle and foot can shoot pain upward.

• Achilles tendonitis: Much like plantar fasciitis, swelling where it inserts below the ankle causes localized and radiating pain.

Risk Factors for Developing Heel and Ankle Pain

Understanding contributing factors that set the stage for plantar fasciitis also explains why and how ankle pain enters the picture in some cases:

• Tight or overworked calf muscles cause strain on the connections from the heel past the ankle. This could come from things like high heel overuse, increasing mileage too quickly when running, or jobs requiring hours of standing such as nursing.

• Excess weight puts more pressure on the plantar fascia ligament and Achilles’ tendon attachment pulling from the heel.

• Flat feet or high foot arches outside the normal range increase risk for pain since the plantar fascia either stretched too much or moves excessively side to side with uneven support.

• Wearing worn out shoes without proper arch and heel support means force isn’t absorbed as well, leading to more tension built lower in the foot.

Symptoms of Plantar Fasciitis Beyond Heel Pain

The classic symptoms that prompt a plantar fasciitis diagnosis include sharp, stabbing pain upon standing after periods of rest. This typically concentrates in a localized spot on the heel, unlike arthritis discomfort that feels more evenly across the whole heel:

• First step pain getting out of bed or after sitting easing somewhat with walking then returning after long periods on your feet.

• Pain walking barefoot around the house, especially on hard flooring without arch support shoes provide.

• Throbbing or burning pain towards the end of the day in the arch or heel areas.

However, if the chronic irritation coming from plantar fasciitis isn’t dealt with through stretching, orthotics, and rest it can lead to pain radiating outward including:

• General arch, foot, or ankle soreness made worse by activity.

• Pain or stiffness higher up radiating through the Achilles’ tendon into the lower part of your ankle with certain movements or pressure.

• Ankle instability or rolling inward easily trying to avoid landing on your sore heel when walking.

• Ankle swelling may develop from compensating with an altered gait.

These types of secondary symptoms demonstrate the importance of resolving the root issue with your plantar fascia through treatment.

Diagnosing the Cause of Ankle and Heel Discomfort

Sorting out what’s behind general heel or ankle pain requires a trip to a podiatrist or orthopedic physician. They’ll take a full history of what movements aggravate it plus a physical exam manipulating the joint to pinpoint the origin.

Diagnostic testing also provides objective confirmation:

• X-rays: Looks for bone spurs, arthritis, or fractures contributing to symptoms.

• Ultrasound imaging: Allows visualizing soft tissue inflammation like plantar fasciitis or tendonitis.

• MRI scans: Gives a detailed view confirming ligament or tendon injury for uncertain cases.

For plantar fasciitis specifically, the podiatrist will check for areas of thickening in the arch/heel ligament insertion point and if pressure reproduces your classic symptoms.

Differential Diagnosis

Since several pathologies can cause hindfoot pain, your doctor considers other possibilities alongside plantar fasciitis such as:

• Tarsal tunnel syndrome

• Fat pad contusion or atrophy

• Calcaneal stress fracture

• Nerve entrapment

• Arthritis

Sorting through these helps guide appropriate treatment whether that’s something like custom orthotics and stretching for plantar fasciitis versus immobilization and pain medication for a heel bone stress fracture.

Treating Ankle Pain from Plantar Fasciitis

Relieving acute inflammation triggering arch and ankle discomfort remains the priority before transitioning to rebuilding strength and flexibility.

Rest and Ice

Lightening up activity that strains the plantar fascia allows the microtearing and irritation to start calming down. Ice massage applied a few times a day can also decrease localized swelling and pain.

Medication

Over-the-counter NSAID medication like ibuprofen reduces inflammation related chemicals causing discomfort. Your doctor may also consider cortisone injections to deliver concentrated anti-inflammatory effects right where needed.

Supportive Devices

Taping or splinting the arch prevents excess motion allowing it to rest. Custom orthotics also provide stability and cushioning to offload strain on the plantar fascia and realign the foot optimally.

Night splints maintaining a gentle stretch on your plantar fascia and Achilles’ tendon while sleeping aids the natural healing process.

Physical Therapy

Once the acute irritation begins resolving, rehab focuses on regaining flexibility and strength. Gentle calf and arch stretches, massage, restorative exercises, and modalities like ultrasound allow gradually transitioning back to normal activity without re-injury.

If ankle instability develops, balancing exercises also retrain stability to prevent rolling or tweaking it constantly.

Preventing Recurrence of Heel and Ankle Discomfort

Completing post-injury rehab fully before ramping activity back up remains critical for preventing repeat bouts of plantar fascitis pain. Continuing home maintenance stretches, wearing supportive shoes, losing excess weight if relevant all help keep it from flaring up again down the road.

Other proactive prevention tips include:

• Build mileage slowly when running and avoid increasing more than 10% per week

• Wear shoes around the house to support your arches if flat feet contribute to plantar fasciitis for you

• Replace athletic shoes around every 300-500 miles of use as shock absorption wears down

• Consider orthotic inserts or arch support shoes if you stand for long periods required by your job

Catching heel pain early on gives you the best chance of resolving discomfort before it spreads into the ankle or elsewhere in the body.

When to See a Doctor

Meeting with a podiatrist for an evaluation is advised if:

• Heel pain lasts over 2 weeks trying conventional treatment like stretching, OTC medication, and supportive shoes

• You develop swelling in the ankle/heel areas

• Pain keeps you from daily activities like standing for your job or walking the dog

• You notice ankle instability or limping that won’t resolve

Diagnostic imaging and advanced treatments like custom orthotics, night splints, focused stretching, extracorporeal shockwave therapy, or possible surgery provide relief when conservative care fails to calm symptoms.

Take Away on Ankle Discomfort Related to Plantar Fasciitis

The foot’s foundational arch ligament plantar fascia serves an important shock absorption and stability function with walking. When overworked and stressed, the inflammation can not only cause classic heel and arch pain but also radiate into the ankle in some instances.

Seeking early treatment options like orthotics, taping, medication, and physical therapy helps calm the irritation before it spreads and causes secondary issues like ankle pain or instability.

With disciplined post-injury rehabilitation, most patients with plantar fasciitis or other foot pain see symptoms eventually resolve allowing full return to activity.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.