Plantar fasciitis refers to an inflammation of the plantar fascia, a thick, fibrous band running along the sole of the foot. Such inflammation results from direct injury to the plantar fascia,
usually, repeated trauma to the tissue where the fascia attaches to the calcaneus or heel bone. The plantar fascia is critical in maintaining the footâs complex arch system, also playing a role in
balance and fine control of certain phases of the athleteâs gait. Injury to the plantar fascia is particularly painful and disabling for runners and can often prove stubbornly resistant to
treatment. Rehabilitation is frequently a lengthy and frustrating process. For these reasons, care should be taken where possible to avoid such injury by means of preventative exercises and
sensitivity to early warning signs.
Plantar fasciitis is common in sports which involve running, dancing or jumping. Runners who overpronate where their feet roll in or flatten too much are particularly at risk the plantar fascia is
over stretched as the foot flattens. A common factor is tight calf muscles which lead to a prolonged or high velocity pronation or rolling in of the foot. This in turn produces repetitive
over-stretching of the plantar fascia leading to possible inflammation and thickening of the tendon. As the fascia thickens it looses flexibility and strength. Other causes include either a low arch
called pes planus or a very high arched foot known as pes cavus. Assessing the foot for plantar fasciitisExcessive walking in footwear which does not provide adequate arch support has been
attributed. Footwear for plantar fasciitis should be flat, lace-up and with good arch support and cushioning. Overweight individuals are more at risk of developing plantar fasciitis due to the excess
weight impacting on the foot.
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 fasciitis is usually diagnosed by your physiotherapist or sports doctor based on your symptoms, history and clinical examination. After confirming your plantar fasciitis they will investigate
WHY you are likely to be predisposed to plantar fasciitis and develop a treatment plan to decrease your chance of future bouts. X-rays may show calcification within the plantar fascia or at its
insertion into the calcaneus, which is known as a calcaneal or heel spur. Ultrasound scans and MRI are used to identify any plantar fasciitis tears, inflammation or calcification. Pathology tests
(including screening for HLA B27 antigen) may identify spondyloarthritis, which can cause symptoms similar to plantar fasciitis.
Non Surgical Treatment
Your health care provider will often recommend these steps first Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) to reduce pain and inflammation. Heel and foot stretching exercises. Night
splints to wear while sleeping to stretch the foot. Resting as much as possible for at least a week. Wearing shoes with good support and cushions. Other steps to relieve pain include aply ice to the
painful area. Do this at least twice a day for 10 - 15 minutes, more often in the first couple of days. Try wearing a heel cup, felt pads in the heel area, or shoe inserts. Use night splints to
stretch the injured fascia and allow it to heal. If these treatments do not work, your health care provider may recommend waring a boot cast, which looks like a ski boot, for 3 - 6 weeks. It can be
removed for bathing. Custom-made shoe inserts (orthotics). Steroid shots or injections into the heel. Smetimes, foot surgery is needed.
The most common surgical procedure for plantar fasciitis is plantar fascia release. It involves surgical removal of a part from the plantar fascia ligament which will relieve the inflammation and
reduce the tension. Plantar fascia release is either an open surgery or endoscopic surgery (insertion of special surgical instruments through small incisions). While both methods are performed under
local anesthesia the open procedure may take more time to recover. Other surgical procedures can be used as well but they are rarely an option. Complications of plantar fasciitis surgery are rare but
they are not impossible. All types of plantar fasciitis surgery pose a risk of infection, nerve damage, and anesthesia related complications including systemic toxicity, and persistence or worsening
of heel pain.