Plantar fasciitis is one of the most common sources of heel pain. Your plantar fascia is a thick fibrous band of connective tissue originating on the bottom surface of the calcaneus (heel bone) and
extending along the sole of the foot towards the toes. Your plantar fascia acts as a passive limitation to the over flattening of you arch. When your plantar fascia develops micro tears or becomes
inflammed it is known as plantar fasciitis.
Plantar fasciitis is caused by straining the ligament that supports your arch. Repeated strain can cause tiny tears in the ligament. These can lead to pain and swelling. This is more likely to happen
if your feet roll inward too much when you walk ( excessive pronation ). You have high arches or flat feet. You walk, stand, or run for long periods of time, especially on hard surfaces. You are
overweight. You wear shoes that don't fit well or are worn out. You have tight Achilles tendons or calf muscles.
Symptoms of plantar fasciitis include pain in the heel of the foot. Some people complain of a sharp stabbing pain especially with walking. Others describe the pain as a dull ache after prolonged
standing. The pain of plantar fasciitis is often worst in the morning or following activity.
Plantar fasciitis is one of many conditions causing "heel pain". Some other possible causes include nerve compression either in the foot or in the back, stress fracture of the calcaneus, and loss of
the fatty tissue pad under the heel. Plantar fasciitis can be distinguished from these and other conditions based on a history and examination done by a physician. It should be noted that heel spurs
are often inappropriately thought to be the sole cause of heel pain. In fact, heel spurs are common and are nothing more than the bone's response to traction or pulling-type forces from the plantar
fascia and other muscles in the foot where they attach to the heel bone. They are commonly present in patients without pain, and frequently absent from those who have pain. It is the rare patient who
has a truly enlarged and problematic spur requiring surgery.
Non Surgical Treatment
A number of conservative measures can help take stress off the plantar fascia and encourage healing, including Icing, Taping the arch and bottom of the foot, Stretching, especially the calf, Avoiding
walking with bare feet, especially on hard surfaces, Wearing orthotics or arch supports, Taking over-the-counter anti-inflammatories. If these methods fail, we generally try one of two things, A
cortisone injection can help reduce swelling. Often a single injection will do the trick, but occasionally a second injection may be needed. Alternatively, we can try extracorporeal pulse activation
therapy, or EPAT. This method uses sound waves to penetrate to the plantar fascia and stimulate the bodyâs healing response. We typically do one treatment a week for three weeks, with complete
healing taking between nine to 12 weeks.
Like every surgical procedure, plantar fasciitis surgery carries some risks. Because of these risks your doctor will probably advise you to continue with the conventional treatments at least 6 months
before giving you approval for surgery. Some health experts recommend home treatment as long as 12 months. If you canât work because of your heel pain, canât perform your everyday activities or
your athletic career is in danger, you may consider a plantar fasciitis surgery earlier. But keep in mind that there is no guarantee that the pain will go away completely after surgery. Surgery is
effective in many cases, however, 20 to 25 percent of patients continue to experience heel pain after having a plantar fasciitis surgery.
More than with most sports injuries, a little bit of prevention can go a long way toward keeping you free from plantar fasciitis. Here are some tips to follow. Wear supportive shoes that fit you
well. When your shoes start to show wear and can no longer give your feet the support they need, it's time to get a new pair. Runners should stop using their old shoes after about 500 miles of use.
Have a trained professional at a specialty running store help you find the right pair for your foot type, and then keep your shoes tied and snug when you wear them. Stay in good shape. By keeping
your weight in check, you'll reduce the amount of stress on your feet. Stretch your calves and feet before you exercise or play a sport. Ask an athletic trainer or sports medicine specialist to show
you some dynamic stretching exercises. Start any new activity or exercise slowly and increase the duration and intensity of the activity gradually. Don't go out and try to run 10 miles the first time
you go for a jog. Build up to that level of exercise gradually. Talk to your doctor about getting heel pads, custom shoe inserts, or orthotics to put in your shoes. Foot supports can help cushion
your feet and distribute your weight more evenly. This is especially true for people with high arches or flat feet. Your doctor will be able to tell you if shoe inserts and supports might lower your
chances of heel injury.