Plantar Fasciitis
Definition of Plantar Fasciitis
Plantar fasciitis is inflammation, usually due to injury, of the plantar fascia, the ligament between the front of the heel bone and the base of the toes that helps to support the arch.
It causes severe pain on the bottoms of the feet, especially in the morning.
Description of Plantar Fasciitis
Excess stress absorbed by the foot may irritate or tear the plantar fascia, making this a common disorder among athletes, especially runners.
Causes and Risk Factors of Plantar Fasciitis
Plantar fasciitis can be caused by a tendency of the foot to roll inward (pronation) upon walking.
Other factors may be stress on the heel due to repeated hard pounding or quick turns, often from long-distance running, jogging, or basketball; wearing shoes that lack proper heel support or that have thin or stiff soles; age-related loss of resiliency in the ligaments; and some forms of arthritis, such as ankylosing spondylitis or Reiter’s syndrome.
Causes of Plantar Fasciitis
Inflammation and pain result from increased activity or in association with aging
Inflammation is usually the result of athletic activity and can be very painful especially in the morning after cramping of feet and legs during sleep
Flat feet or high arched, rigid feet
Poor supporting shoes
Large weight gain in short period of time
Other family member with plantar fasciitis
Running on hills or balls of feet
Running on uneven surfaces
Symptoms of Plantar Fasciitis
Plantar fasciitis occurs only on the sole and heel of the foot. It can cause pain along the entire length of the plantar fasciae and where these ligaments attach to the heel bone in the rear foot and the five metatarsal bones.
Patients often report severe pain on the bottoms of their feet in the morning, especially the first steps out of bed. The pain subsides after a few minutes of walking.
Diagnosis of Plantar Fasciitis
The diagnosis is made by medical history and physical exam.
Treatment of Plantar Fasciitis
In severe cases, a corticosteroid injection into the tender area may provide relief. Rarely, surgery to release the plantar fascia from its attachment may be necessary.
Self Care
Rest the foot as much as possible, especially during the first week. Avoid jogging, running, and excess standing; instead, substitute exercises that do not put undue stress on the injured ligament, like bicycling or swimming.
Apply ice to the tender area a few times daily to reduce inflammation. Try rolling the arch of the foot over an empty tennis ball can that has been filled with water and frozen; this both cools and stretches the affected area.
Take over-the-counter pain relievers (ibuprofen, naproxen) to reduce pain and inflammation.
Insert an over-the-counter arch support and heel support cushion into the shoe. Cut a hole in the pad to relieve pressure on the tender area if necessary. Try to avoid walking barefoot, since it may put added stress on the plantar ligament.
Sit on a table with your knees bent. Loop a towel under the ball of the injured foot and pull, flexing the front of your foot upward. Keep your knee bent and try to press your foot against the towel.
Sit on a chair and cross the ankle of the injured foot over the opposite knee. Slowly push the toes backward with your hand until you feel the stretch in the bottom of your foot.
Stand facing a wall, about one foot away, with the injured foot about six inches farther back. Put your hands on the wall and gently lean forward, stretching the lower calf.
Stand facing a wall, about two feet away, with the injured foot about six inches farther back. Keep both feet slightly turned outward. Put your hands on the wall and gently lean forward, bending the front knee and keeping the back heel on the floor.
Use the Clinitex� HealWell� Night Splint to maintain a gentle, constant stretch across the plantar fascia.
Wear proper shoes. Running or sports shoes with excellent support, no or minimal heel, and well cushioned soles. Padded or gel inserts or arch supports may also be used.
Use heel pads. Felt, gel, viscoelastic, or synthetic heel pads spread and absorb shock as the heel lands easing pressure on the plantar fascia.
Decrease standing and ambulatory activity.
Get periods of ”relative rest” and ice to reduce inflammation (problem often reoccurs if one rests completely).
Stretch the heel cord and plantar fascia.
Perform stretching exercises followed by icing.
Massage area of pain, especially in morning after worm bath or shower.
Wear Birkenstock typ sandal instead of bare feet or slippers.
Tape to maintain arch and release tension off plantar fascia.
Lose weight.
Non-steroidal anti-inflammatory medication to reduce pain and inflammation.
In Extreme cases of plantar faciitis:
Cortisone injections
Physical therapy to decrease pain and inflammation and strengthen foot muscles to support weakened plantar fascia
Ultrasound to decrease inflammatory response
Surgery (extremely rare). An incision over the inner aspect of the heel of foot with release of involved fascia from its’ attachment to heel bone
