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Plantar fasciitis is a disorder of the connective tissue which supports the arch of the foot. It results in pain in the heel and bottom of the foot that is usually most severe with the first steps of the day or following a period of rest. Pain is also frequently brought on by bending the foot and toes up towards the shin. The pain typically comes on gradually, and it affects both feet in about one third of cases. 
The causes of plantar fasciitis are not entirely clear. Risk factors include overuse such as from long periods of standing, an increase in exercise, and obesity. It is also associated with inward rolling of the foot, a tight Achilles tendon, and a lifestyle that involves little exercise. While heel spurs are frequently found it is unclear if they have a role in causing the condition. Plantar fasciitis is a disorder of the insertion site of the ligament on the bone characterized by micro tears, breakdown of collagen, and scarring. Since inflammation plays either a lesser or no role, a review proposed it be renamed plantar fasciosis The diagnosis is typically based on signs and symptoms; ultrasound is sometimes useful. Other conditions with similar symptoms include osteoarthritis, ankylosing spondylitis, heel pad syndrome, and reactive arthritis. 
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