Plantar Fasciitis

Plantar fasciitis is the most common cause of heel pain. Plantar fasciitis is the medical term used to describe an inflamed plantar fascia ligament. The plantar fascia is a thick, bowstring-like ligament that connects your heel bone to your toes and provides support for the arch of the foot.

COMMON CAUSES OF PLANTAR FASCIITIS

Plantar fasciitis is caused by straining the plantar fascia ligament. Repeated stress on the plantar fascia can cause tiny tears in the ligament, which can lead to pain and swelling. The main causes of excessive stress on the foot include:

  • Biomechanical factors, such as:
    • Flat feet, meaning the foot arch collapses while bearing weight and causes the plantar fascia to be stretched away from the heel bone
    • Excessive pronation, which causes abnormal twisting or rolling of the foot
    • High arches, which causes excessive stretching of the plantar fascia
    • Tight calf muscles pull on the Achilles’ tendon and creates tension on the plantar fascia
  • Repetitive stress from activities such as jobs that require prolonged walking or standing, or sports such as running.
  • Things that put additional stress on your feet, such as being overweight or wearing shoes that do not fit properly, lack adequate cushion, or are worn out.
  • Natural part of the aging process. Plantar fasciitis is most common among middle-aged adults.

Anyone can develop plantar fasciitis, but there are some individuals that are more at risk than others. Some risk factors are related to body type, age, gender, and activity level.

SYMPTOMS
  • Heel pain
  • Foot pain
  • Stiffness
  • Tenderness
DIAGNOSIS

Plantar fasciitis is diagnosed by a physical examination of the foot. Your physician will check from pain and tenderness, observe you stand and walk, evaluate muscle strength and nerve health, as well as use x-rays to confirm nothing else is causing your heel pain.

TREATMENT OPTIONS

Most people with plantar fasciitis respond well to conservative treatments, such as resting, icing, and stretching. Conservative treatment can take several months before the pain effects of plantar fasciitis subside. Additional conservative treatment options include:

  • Medications: over-the-counter pain relievers such as ibuprofen (Advil, Motrin IB) and naproxen sodium (Aleve) can help reduce inflammation and treat the painful symptoms associated with plantar fasciitis.
  • Physical Therapy: specific exercises can be used to stretch the Achilles tendon and strengthen the muscles of the lower leg. This helps provides stability to the ankle and heel.
  • Night Splints: are used to stretch the calf muscles and the arch of your foot while you sleep. Splints also hold the plantar fascia and Achilles tendon in an elongated position overnight, which helps facilitate stretching.
  • Orthotics: your physician may recommend over-the-counter or custom-fitted arch supports to help distribute pressure more evenly across the foot.
  • Injections: steroid injections can provide temporary pain relief to tender areas of the foot.
SURGICAL PROCEDURE

If conservative measures do not relieve the symptoms associated with plantar fasciitis, your physician may recommend surgery. In general, surgery is only considered if you continue to have severe, disabling symptoms, for at least 6 to 12 months, despite careful attention to home and other nonsurgical treatments. The surgical procedure involves cutting part of the plantar fascia ligament to release tension and relieve inflammation. After surgery, you will be required to wear a non-weight-bearing cast or brace for 2 to 3 weeks while the tissue heals. You will being a gradual strengthening and flexibility program.

Plantar Fasciitis: Stretching, Massaging, and Taping Technique