Foot

Plantar Fasciitis

The plantar fascia is a ligament structure that supports the longitudinal arch of the foot. It is a tough, fibrous band of connective tissue that runs from the heel bone to the base of the toes. Plantar Fasciitis is caused by repetitive strain and a common cause of localized heel pain. It is an inflammation of the plantar fascia and is a clinical diagnosis based on a history and examination completed by a physician.

Symptoms of Plantar Fasciitis

  • Starts as dull, intermittent pain in heel or arch, progressing to a sharp, persistent pain
  • A sharp, piercing pain and/or inflammation through heel and foot that usually occurs in the morning or after resting and gradually disappears with walking
  • Tightness in calf muscles
  • Symptoms may be spontaneous

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
  • Poorly designed athletic footwear
  • 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

Treatments for Plantar Fasciitis:

  • Stretch the heel cord and plantar fascia.
  • Perform stretching exercises followed by icing.
  • Use a 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).
  • Massage area of pain, especially in morning after worm bath or shower.
  • Taping programs, to maintain arch and release tension off plantar fascia.
  • Weight Loss.
  • Non-steroidal anti-inflammatory medication to reduce pain

In Extreme Cases of Plantar Fasciitis:

  • A cortisone injection may be needed
  • Physical therapy to decrease pain and inflammation and strengthen foot muscles to support weakened plantar fascia
  • Physical therapy modalities (such as 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.

Plantar Fascial Stretching:

Stretch #1
  • Step l - Position yourself with the ball of your foot on the edge of stair.
  • Step 2 - Holding the rails for balance allow your heels to sink downwards. You should be relaxed and no active muscle contraction in your legs should be necessary.
  • Step 3 - Hold this position for 4 to 5 minutes.
Stretch #2
  • Step 1 - Roll a towel tightly so that its diameter is 1 to 1 inches.
  • Step 2 - With your toes of the leg to be stretched approximately 1 12 feet away from a table or a wall, place the towel under your toes but allow the ball of your foot to rest on the ground.
  • Step 3 - Place your opposite leg straight back for balance.
  • Step 4 - Keeping your heel on the ground, now force your knees towards the wall.
  • Step 5 - This position is difficult to maintain for long periods of time, but the longer you can do it the better.

Minimum time for each stretch should be 30 seconds. Total stretching time 2 to 3 minutes should suffice.