Plantar fasciitis is the most common cause of heel pain. The plantar fascia camera.gif is the flat band of tissue (ligament) that connects your heel bone to your toes. It supports the arch of your
foot. If you strain your plantar fascia, it gets weak, swollen, and irritated (inflamed). Then your heel or the bottom of your foot hurts when you stand or walk. Plantar fasciitis is common in
middle-aged people. It also occurs in younger people who are on their feet a lot, like athletes or soldiers. It can happen in one foot or both feet.
Because the plantar fascia supports your foot and gets used every time you take a step, it has to absorb a large amount of stress and weight. If too much pressure is put on the plantar fascia, the
fibers can become damaged or start to tear. The body responds by causing inflammation in the affected area. This is what causes the pain and stiffness of plantar fasciitis. Things that can increase
the risk of plantar fasciitis include tight calf muscles. Tight calves make it harder to flex your foot, and this puts more stress on the plantar fascia. Weight. Carrying a few extra pounds puts
added pressure on your feet every time you take a step. Activities that put a lot of stress on the feet. This includes things like running, hiking, dancing, and aerobics. Bad shoes. Footwear that
doesn't give your foot the support it needs increases your risk of plantar fasciitis. You'll want to ditch any shoes that have thin soles or inadequate arch support, or ones that don't fit your feet
properly. Routinely wearing high heels can also cause your Achilles tendon to contract over time, making it harder to flex your foot. Jobs that involve a lot of standing or walking on hard surfaces.
Jobs that keep you on your feet all day, like waiting tables or working in a store, can cause damage to your plantar fascia. High arches, flat feet, or other foot problems. The shape of your foot can
affect the way your weight is distributed on your feet when you stand. If weight distribution is a bit off, it can add to a person's risk of plantar fasciitis. How someone walks can increase the
stress on certain parts of the foot too.
Plantar fasciitis sufferers feel a sharp stab or deep ache in the middle of the heel or along the arch. Another sign is the morning hobble from the foot trying to heal itself in a contracted position
overnight. Taking that first step causes sudden strain on the bottom of the foot. The pain can recur after long spells of sitting, but it tends to fade during a run, once the area is warmed up.
Plantar fasciosis is confirmed if firm thumb pressure applied to the calcaneus when the foot is dorsiflexed elicits pain. Fascial pain along the plantar medial border of the fascia may also be
present. If findings are equivocal, demonstration of a heel spur on x-ray may support the diagnosis; however, absence does not rule out the diagnosis, and visible spurs are not generally the cause of
symptoms. Also, infrequently, calcaneal spurs appear ill defined on x-ray, exhibiting fluffy new bone formation, suggesting spondyloarthropathy (eg, ankylosing spondylitis, reactive arthritis. If an
acute fascial tear is suspected, MRI is done.
Non Surgical Treatment
Over-the-counter arch supports may be useful in patients with acute plantar fasciitis and mild pes planus. The support provided by over-the-counter arch supports is highly variable and depends on the
material used to make the support. In general, patients should try to find the most dense material that is soft enough to be comfortable to walk on. Over-the-counter arch supports are especially
useful in the treatment of adolescents whose rapid foot growth may require a new pair of arch supports once or more per season. Custom orthotics are usually made by taking a plaster cast or an
impression of the individual's foot and then constructing an insert specifically designed to control biomechanical risk factors such as pes planus, valgus heel alignment and discrepancies in leg
length. For patients with plantar fasciitis, the most common prescription is for semi-rigid, three-quarters to full-length orthotics with longitudinal arch support. Two important characteristics for
successful treatment of plantar fasciitis with orthotics are the need to control over-pronation and metatarsal head motion, especially of the first metatarsal head. In one study, orthotics were cited
by 27 percent of patients as the best treatment. The main disadvantage of orthotics is the cost, which may range from $75 to $300 or more and which is frequently not covered by health
If you consider surgery, your original diagnosis should be confirmed by the surgeon first. In addition, supporting diagnostic evidence (such as nerve-conduction studies) should be gathered to rule
out nerve entrapment, particularly of the first branch of the lateral plantar nerve and the medial plantar nerve. Blood tests should consist of an erythrocyte sedimentation rate (ESR), rheumatoid
factor, human leukocyte antigen B27 (HLA-B27), and uric acid. Itâs important to understand that surgical treatment of bone spurs rarely improves plantar fasciitis pain. And surgery for plantar
fasciitis can cause secondary complications-a troubling condition known as lateral column syndrome.
Stretching exercises for your foot are important. Do the stretches shown here at least twice a day. Don't bounce when you stretch. Plantar fascia stretch. To do the plantar fascia stretch, stand
straight with your hands against a wall and your injured leg slightly behind your other leg. Keeping your heels flat on the floor, slowly bend both knees. You should feel the stretch in the lower
part of your leg. Hold the stretch for 10 to 15 seconds. Repeat the stretch 6 to 8 times. Calf stretch. Stand with your hands against a wall and your injured leg behind your other leg. With your
injured leg straight, your heel flat on the floor and your foot pointed straight ahead, lean slowly forward, bending the other leg. You should feel the stretch in the middle of your calf. Hold the
stretch for 10 to 15 seconds. Repeat the stretch 6 to 8 times. Other exercises. You can also strengthen your leg muscles by standing on the ball of your foot at the edge of a step and raising up as
high as possible on your toes. Relax between toe raises and let your heel fall a little lower than the edge of the step. It's also helpful to strengthen the foot by grabbing a towel with your toes as
if you are going to pick up the towel with your foot. Repeat this exercise several times a day.