Plantar
Fasciitis
What
Is Plantar Fasciitis?
Plantar fasciitis is the most common cause of pain on the bottom of
the heel. Usually indicated by pain in the first steps of the morning.
Pain also occurs with the onset of activity such as walking and running,
which subsides as activity rogresses, and usually returns after resting
and then resuming activity. Plantar Fasciitis is considered a chronic
inflammatory response rather than an acute injury. It is common in runners
performing repetitive plantar flexion and dorsiflexion of the toes.
It is also common with sudden weight gain.
The plantar fascia provides support for the medial longitudinal arch
of the foot. The plantar fascia is stretched and the arch flattens slightly
to absorb the impact each time the heel impacts the ground. The fascia
is not very flexible and such repetitive stretching from impact can
result in small tears in the fascia.
Signs
And Symptoms of Plantar Fasciitis
Heel pain
during the first steps of the morning is a classic sign of plantar fasciitis.
This pain is the result of the foot resting in plantar flexion overnight.
This allows the fascia to shorten. When the shortened fascia is stretched
pain occurs. Pain is also common at the start of exercise and when resuming
activity after rest. A history of recent weight gain or a sudden change
in exercise pattern also is a sign of plantar fasciitis.
Pain continues due to the chronic inflammation of the torn fascia. A
heel spur can be a sign of fasciitis, but is typically not a cause.
About half of patients with plantar fasciitis have spurs.
Causes of Plantar Fasciitis
Typical causes
of Plantar Fasciitis include overstretching a tight plantar fascial
band or general overuse causing microtears to the fascia at its calcaneal
origin.
Predisposing factors include:
Flat
feet
High arches
Excessive pronation
Obesity or sudden weight gain
Tight achilles tendons
Sudden increase in activity intensity, time or type
Wearing shoes with poor cushioning
Change in running or walking surface
Occupation with prolonged standing / weight bearing
Treatment
of Plantar Fasciitis
NSAIDs, or
Nonsteroidal anti-inflammatory drugs (aspirin, ibuprofen (Advil or Motrin),
naproxen sodium (Aleve), and ketoprofen (Orudis KT)) can be used for
2-4 weeks in conjunction with other treatments. (Check with your doctor
for specific instructions).
It is important for those with plantar faciitis to avoid irritating
activities, and barefoot walking on hard surfaces. Other treatments
include weight loss when appropriate, heel cord (achilles) and plantar
fascia stretching. Taping the heel and arch may also help reduce pain.
Medial longitudinal arch supports, can be used if they produce a positive
result.
Massaging the fascia by rolling foot over a 3-4 inch diameter tube such
as a rolling pin or soup can has be an effective treatment. The next
level would be Proprioceptor exercises.
Strengthening exercises include scrunching up a hand towel with the
toes or pulling a towel weighted with a soup can across the floor. After
exercising, applying a cold pack to heel at point of maximal tenderness
for 15-20 minutes can relieve pain. The next level would be foot strengthening
exercises with Jumpsoles Proprioceptors.
Proper footwear with arch support is also recommended.
Any foot injury that does not respond to treatment in 1-2 weeks may
be more serious. Always consult a physician for a thorough evaluation
and diagnosis.
