Is Plantar Fasciitis
causing your heel pain?

Plantar fasciitis is a painful foot condition. When you can’t walk, life slows down. Learn the steps you can take to get back on your feet again.




What is Plantar Fasciitis?

The plantar fascia is the broad ligament that extends from the heel bone, or calcaneous, to the metatarsals, or ball of the foot. The plantar fascia functions to help support the medial arch of the foot. Plantar fasciitis is inflammation of this tissue.

Fasciitis is also often related to heel spurs. X-rays of the foot can demonstrate the presence of a heel spur. However, spurs themselves are not painful. Rather, it is the spur pressing into the plantar fascia that causes the pain. Thus, even with the presences of a heel spur, treatment can be successful in reducing pain.


Plantar Fasciitis


Symptoms of Plantar Fasciitis


The most common compliant with this condition is heel pain, specifically with the first steps in the morning. Generally as soon as you put pressure on your foot the pain starts. Pain generally extends from the heel into the medial arch of the food.

Typically, as you begin to walk more, the symptoms improve as the plantar fascia stretches. However, as the day goes on, with increased walking and standing, pain will return.


Causes of Fasciitis

Most often, symptoms of plantar fasciitis gradually increase over time. Flat feet, or foot pronation, are frequent contributors of this condition. Most importantly, plantar fasciitis occurs when pronated feet are combined with wearing unsupportive footwear and prolonged standing and walking.

Foot Pronation


In situations in which a trauma occurs, such a traumatic landing on the heel, other structures other then just the plantar fascia can be involved. In such situations, the calcaneous itself can become fractured. In addition, a fat pad protects the plantar aspect of the calcaneous. This fat pad has numerous nerves making it very painful when injured.


Typical Conservative Treatment

As plantar fasciitis is an inflammatory condition, reducing inflammation is the first line of treatment. Oral anti-inflammatory medication and anti-inflammatory creams can assist in reducing inflammation (consult your doctor regarding medications).

The use of ice therapy is also a key in reducing inflammation of local tissues. Because of the superficial nature of the plantar fascia, ice massage is an effective means of icing. To use ice massage, fill Styrofoam cups with water and freeze them. Once the water is frozen, peel off the rim of the cup to expose the ice. Massage the exposed ice over the heel for 5 minutes. Another way of icing the plantar fascia is to freeze a water bottle, then massage the arch over the frozen bottle.


heel ice massage


Of primary importance in to the treatment protocol is wearing appropriate shoe wear. For pronated feet, running shoes are generally the best at controlling excessive foot motion and minimizing tissue stress. Running shoes that are labeled as ‘motion control’ or ‘stability’ are generally best for pronated feet. In certain cases, the use of a custom shoe insert is warranted. As custom orthotics can be expensive, a good over-the-counter shoe insert is the "Superfeet" brand and can generally be found in sporting good stores.


Foot pronation


To help minimize the soft tissue tightness that be created at night, try wearing a night splint. The splint functions in keeping the fascia and calf in a prolonged stretched position. Maintaining this tissue flexibility will help minimize the pain that occurs with the first steps in the morning. Although this treatment option can be effective, many struggle with the discomfort of wearing the brace and getting a good night sleep.


night splint for plantar fasciitis


Physical Therapy

Addressing the soft tissue tightness must be part of a successful treatment program. Physical therapy treatment in part focuses on improving the soft tissue mobility of the plantar fascia, generally via massage. To massage the plantar fascia at home, rest your arch over a tennis or racquet ball and apply light pressure rolling the arch over the ball.

Stretching of both the plantar fascia and the calf muscle helps to minimize pain. Therefore, stretching exercises are important to the treatment program.

Being that a flexible, pronated foot is most often associated with plantar fascia pain, strengthening of muscles that support the arch can help to minimize stress on the plantar fascia.

Of of the best stretches for plantar fascia pain is the standing calf stretch. Do this stretch frequently, specifically in the morning when you first get up. Hold the stretch a minimum of 60 seconds and repeat frequently.

calf stretch



Summary

• Plantar fasciitis is inflammation of the plantar fascia, the broad ligament on the bottom of the foot.

• Symptoms generally involve pain with walking, especially in the morning.

• Causes are often associated with foot biomechanics.

• Of primary importance in treating plantar fascia pain is shoe selection.

• Ice, medication, massage, and night splints can help improve heel pain.


Recovering from plantar fascia pain can be a slow process, but consistently following the recommendations will help you get out of pain faster.

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