Basics of Plantar Fasciitis

Plantar fasciitis is a common orthopedic condition that affects the heel and the bottom of the foot. It is characterized by inflammation of the plantar fascia, a thick band of tissue that connects the heel bone to the toes. This condition often causes significant heel pain and can impair a person’s ability to walk and engage in daily activities. In this post, we’ll explore some basic aspects of plantar fasciitis, including its symptoms, causes, evaluation, treatment options, and advice for preventing recurrence.

Causes and Diagnosis

Plantar fasciitis typically manifests as sharp, stabbing heel or bottom of foot pain, usually experienced in the morning when the first steps are taken after waking up. The pain may also worsen after prolonged periods of standing or sitting. The bottom of the heel is the most common location for discomfort, although it can also extend along the arch of the foot.

Several factors can contribute to the development of plantar fasciitis. One of the primary causes is excessive or repetitive strain on the plantar fascia. This can result from activities that put stress on the feet, such as running, jumping, or walking long distances. Additionally, individuals who are overweight or obese are at a higher risk due to the increased pressure on their feet.

Poor foot mechanics, such as flat feet or high arches, can also strain the plantar fascia, leading to inflammation and pain. Tight calf muscles and Achilles tendons can contribute to the condition by limiting ankle flexibility, altering the way the foot strikes the ground during walking or running.

Diagnosing plantar fasciitis typically involves a thorough physical examination and a review of your medical history. Usually, you’re asked about the nature and duration of the pain, as well as any activities that aggravate or alleviate the symptoms. During a physical examination, a doctor or physical therapist may press on the bottom of the foot to identify tender areas and assess the range of motion in the ankle and foot joints.

Sometimes, imaging studies such as X-rays or ultrasound may be ordered to rule out other conditions and to get a better view of the affected area. These tests can help confirm the diagnosis and determine the severity of the condition.

Treatment

The treatment of plantar fasciitis focuses on alleviating pain, reducing inflammation, and promoting healing. Conservative measures are often the first line of treatment and may include:

• Rest and Activity Modification: Resting the affected foot and avoiding activities that worsen the pain, such as excessive walking or running, can help in the healing process.
• Ice Therapy: Applying ice to the affected area can help reduce inflammation and alleviate pain. Ice packs can be applied for 15-20 minutes several times a day.
  Stretching Exercises: Stretching exercises for the calf muscles and Achilles tendon can improve flexibility and reduce strain on the plantar fascia. These exercises are often recommended as part of a daily routine.
• Orthotic Devices: Custom-made or over-the-counter orthotic insoles can provide support to the arch and help distribute pressure more evenly across the foot. Orthotics may be prescribed for different lengths of time and during certain activities and are not necessarily meant to be used forever.
• Night Splints: Night splints are devices worn during sleep to keep the foot in a dorsiflexed position, stretching the plantar fascia and Achilles tendon.
• Physical Therapy: Physical therapy sessions may include exercises, stretches, and manual therapies to improve foot and ankle strength and flexibility.
• Anti-inflammatory Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help reduce pain and inflammation.

In cases where conservative treatments do not provide relief, more advanced interventions may be considered, such as:

• Corticosteroid Injections: Injections of corticosteroids into the affected area can provide temporary relief from pain and inflammation.
• Extracorporeal Shock Wave Therapy (ESWT): ESWT is a non-invasive procedure that uses shock waves to stimulate healing and reduce pain.
• Tenex Procedure: This is a minimally invasive procedure that involves removing damaged tissue from the plantar fascia using ultrasound-guided technology.
• Surgery: In rare and severe cases that do not respond to other treatments, surgical procedures to release the tension in the plantar fascia may be considered.

Preventing Recurrence

Preventing recurrence involves addressing the underlying causes and making lifestyle changes to reduce the risk of reinjury. Here are some recommendations we found for preventing the recurrence of plantar fasciitis:

• Proper Footwear: Wearing supportive shoes with cushioned soles and good arch support is crucial. Avoid high heels and worn-out shoes that no longer provide adequate support.
• Gradual Activity: When starting a new exercise routine or increasing the intensity of physical activities, it is essential to do so gradually. Sudden increases in activity can strain the plantar fascia.
• Stretching: Regularly stretching the calf muscles and Achilles tendon can improve flexibility and reduce strain on the plantar fascia. Incorporate stretching exercises into the daily routine, especially before and after exercise.
• Maintain a Healthy Weight: Being overweight increases the pressure on the feet, contributing to the development and recurrence of plantar fasciitis. Maintaining a healthy weight through proper diet and exercise can reduce the risk.
• Orthotic Support: If your foot mechanics are a contributing factor, wearing custom-made (prescribed) or over-the-counter orthotic insoles can provide additional support and prevent excessive strain on the plantar fascia.
• Icing and Rest: In cases of minor foot discomfort or after engaging in activities that stress the feet, applying ice and taking time to rest can prevent the exacerbation of symptoms.
• Regular Exercise: Engaging in regular physical activity not only helps maintain a healthy weight but also promotes overall foot and ankle strength. Strong muscles provide better support to the feet, reducing the risk of injuries.
• Listen to Your Body: Pay attention to any signs of discomfort or pain in the feet. If your symptoms persist or worsen, it is essential to seek medical advice promptly to prevent the condition from progressing.

 

To close, plantar fasciitis is a common and frequently debilitating condition that can significantly impact your quality of life. Timely diagnosis and appropriate management, including conservative treatments and/or lifestyle modifications, are essential for effective relief from symptoms. By understanding the underlying causes, following recommended treatments, and adopting preventive measures, you can reduce the risk of recurrence and maintain optimal foot health.

 

Resources

https://www.mayoclinic.org/diseases-conditions/plantar-fasciitis/symptoms-causes/syc-20354846
https://my.clevelandclinic.org/health/diseases/14709-plantar-fasciitis
https://www.ncbi.nlm.nih.gov/books/NBK431073/
https://www.physio-pedia.com/Plantar_Fasciitis