What is Plantar Fasciitis?
What is it?
Plantar Fasciitis (pronounced plan-tar fash-ee-eye-tis) is a common cause of heel and foot pain in adults. “Plantar” means the bottom of the foot; “fascia” is a type of connective tissue, and “itis” means “inflammation”. The classic symptoms of plantar fasciitis include heel pain that is usually most severe first thing in the morning. This condition is characterized by inflammation at the insertion point of the plantar fascia on the heel bone.
Plantar fascia is a layer of tough fibrous tissue that runs along the bottom of your foot and supports your arch. This is one of the longest and strongest ligaments in the body. As the plantar fascia pulls on the heel, your body will respond by laying down more bone in the area. This can be seen on an x-ray and is known as a heel spur.
Common contributors to this condition include: progressive flattening of the arches over time (primary reason); lack of flexibility in the calf muscles; changes in activity levels; overuse; and weight gain. When your arch drops, the plantar fascia begins to tear away from its insertion at your heel. When this happens over a long period of time, it can overcome the body’s ability to repair itself.
There are two main concepts in the treatment of plantar fasciitis: the decrease of inflammation and addressing the cause of the condition.
- Stretching and Exercise: Increasing the length of the calf muscles is a very important part of any treatment. Tightness in this muscle group can force excess pronation (arch drop), which may contribute to plantar fasciitis because a falling arch spreads the fascia and increases tension on the heel. Other stretching exercises are aimed at lengthening the plantar fascia in an attempt to reduce the pull on your heel, like adding slack to the rope that is yanking on your heel.
- Anti-Inflammatory Agents: These may include ice and oral anti-inflammatory medications. These may provide some temporary relief from the pain of inflammation.
- Night Splints: A device worn at night to prevent contraction of the plantar fascia and to maintain calf flexibility. These will usually lessen the “first step in the morning” pain and relieve symptoms temporarily. They can be uncomfortable to wear for some, but generally provide some relief.
- Corticosteroid Injections: This involves the injection of a steroid directly into the heel and site of inflammation. Usually reserved for intractable or difficult cases, this may provide more relief than oral anti-inflammatory medications. Talk to us about the indications and risks for this treatment.
- Extracorporeal Shock Wave Therapy: A high or low impact shock wave is delivered to the area in an attempt to speed the healing process. Usually 1 to 3 treatments are required, and depending on the intensity of the wave an anesthetic may be used.
Foot Orthotics & Internal Stent Stabilization: The proper custom orthotics or stents are often the best defence in the prevention of plantar fasciitis and the most reliable long-term cure for existing conditions. A restored arch significantly reduces the daily pull on the plantar fascia by relaxing the ‘bowstring” function of the fascia. It is the only practical way to address both the symptoms AND the cause of your problem.
May is foot health month. Don’t ignore your tootsies! For the podiatrist nearest you: www.opma.ca