Plantar Fasciitis

Have you ever had fear of standing back up after resting from the run or walk you just accomplished 20 minutes ago? 

Ever wake up in the morning, step out of bed and feel a sharp pain on the bottom of your foot? 

You might realize that you walk dependently on the outside edge of the foot to avoid placing pressure on the painful heel/sole of the feet. If you just had a ‘light bulb moment’, you likely have the most common heel pain condition in adults – Plantar Fasciitis.

What is plantar fasciitis?

Plantar fasciitis is one of the most common causes of heel pain. The plantar fascia is a broad ligament-like structure that extends from the heel bone to the base of the toes, acting like a thick rubber band on the bottom arch of the foot

Plantar fasciitis commonly causes stabbing pain that usually occurs with your first steps in the morning. As you get up and move, the pain normally decreases, but it might return after long periods of standing or when you stand up after sitting.

What causes plantar fasciitis?

The function of the plantar fascia is to absorb the impact of standing, walking, and running on the foot. This part of the body gets a lot of use, and too much pressure can damage the plantar fascia.

Even though plantar fasciitis can develop without an obvious cause, some factors can increase your risk of developing this condition. They include:

  • Age. Plantar fasciitis is most common between the ages of 40 and 60.
  • Certain types of exercise. Activities that place a lot of stress on your heel and attached tissue — such as long-distance running, ballet dancing and aerobic dance — can contribute to the onset of plantar fasciitis.
  • Foot mechanics. Flat feet, a high arch or even an abnormal pattern of walking can affect the way weight is distributed when you’re standing and can put added stress on the plantar fascia.
  • Foot Wear. Wearing footwear with poor arch support such as high heeled shoes  or worn out shoes with thin soles can result in plantar fasciitis
  • Obesity. Excess weight put extra stress on your plantar fascia.
  • Occupations that keep you on your feet. Factory workers, teachers and others who spend most of their work hours walking or standing on hard surfaces can damage the plantar fascia.

How is it diagnosed?

Plantar fasciitis is diagnosed based on your medical history and physical examination

A physical examination is done to check for tenderness in your foot and the exact location of the pain. This is to make sure that the pain isn’t the result of a different foot problem.

During the evaluation, the doctor may ask you to flex your foot while they push on the plantar fascia to see if the pain gets worse as you flex and better as you point your toe. They’ll also note if you have mild redness or swelling.

Your doctor will evaluate the strength of your muscles and the health of your nerves by checking:

  • reflexes
  • muscle tone
  • sense of touch and sight
  • coordination
  • balance

 Usually no imaging tests are necessary.

 Your doctor might suggest an X-ray or magnetic resonance imaging (MRI) to make sure another problem, such as a stress fracture, is not causing you pain

Is plantar fasciitis treatable?

Most people who have plantar fasciitis recover in several months with conservative treatment such as

  • Physical therapy.  Exercises to stretch the plantar fascia and Achilles tendon and to strengthen lower leg muscles. 
  • Night splints. A health care professional might recommend that you wear a splint that stretches your calf and the arch of your foot while you sleep. This holds the plantar fascia and Achilles tendon in a lengthened position overnight to promote stretching.
  • Orthotics.  Off-the-shelf or custom-fitted arch supports (orthotics) to help distribute pressure to your feet more evenly.

If more-conservative measures aren’t working after several months, these methods are recommended:

  • Injections. Injecting steroid medication into the tender area can provide instant pain relief. Platelet-rich plasma obtained from the patient’s own blood can also be injected to promote tissue healing
  • Extracorporeal shock wave therapy. In this procedure, sound waves are directed at the area of heel pain to stimulate healing. It’s usually used for chronic plantar fasciitis that hasn’t responded to more-conservative treatments. Studies have shown ESWT can contribute to healing and pain reduction in plantar fasciitis
  • Surgery. Few people need surgery to detach the plantar fascia from the heel bone. It is generally an option only when the pain is severe and other treatments have failed.

The important factor to consider who to seek help from is not to know who can provide the best, but to understand which therapy suits you best. Get your life back and live pain free!

Speak to a doctor to find out what is the best treatment option for you.

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