Plantar fasciitis is one of the most common explanations of heel pain. It is caused by inflammation to the thick band that connects the toes to the heel bone, called the plantar fascia, which runs
across the bottom of your foot. The condition is most commonly seen in runners, pregnant women, overweight people, and individuals who wear inadequately supporting shoes. Plantar fasciitis typically
affects people between the ages of 40 and 70.
Plantar Fasciitis is simply caused by overstretching of the plantar fascia ligament under the foot. So why is the ligament being overstretched? There are different factors, over-use, too much sports,
running, walking or standing for long periods (e.g. because of your job) weight gain, our feet are designed to carry a 'normal' weight. Any excess weight places great pressure on the bones, nerves,
muscles and ligaments in the feet, which sooner or later will have consequences. Even pregnancy (in the last 10 weeks) can cause foot problems! age, as we get older ligaments become tighter &
shorter and msucles become weaker; the ideal circumstances for foot problems, unsupportive footwear, 'floppy' shoes with no support as well as thongs affect our walking pattern, walking barefoot,
especially on hard surfaces like concrete or tiles, low arch and flat feet or over-pronation. An important contributing factor to Plantar Fasciitis is 'excess pronation' (or over-pronation). This is
a condition whereby the feet roll over, the arches collapse and the foot elongates. This unnatural elongation puts excess strain on the ligaments, muscles and nerves in the foot. When the foot is not
properly aligned, the bones unlock and cause the foot to roll inward. With every step taken your foot pronates and elongates, stretching the plantar fascia and causing inflammation and pain at the
attachment of the plantar fascia into the heel bone. Re-alignment of the foot should therefore an important part of the treament regime.
Most patients with plantar fasciitis describe a sharp or stabbing pain on the bottom of the heel that is most severe when they first get up in the morning or after a period of resting. Some may feel
like the heel is bruised while others may describe tightness or even a pulling sensation on the heel or arch.
X-rays are a commonly used diagnostic imaging technique to rule out the possibility of a bone spur as a cause of your heel pain. A bone spur, if it is present in this location, is probably not the
cause of your pain, but it is evidence that your plantar fascia has been exerting excessive force on your heel bone. X-ray images can also help determine if you have arthritis or whether other, more
rare problems, stress fractures, bone tumors-are contributing to your heel pain.
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.
Most patients have good results from surgery. However, because surgery can result in chronic pain and dissatisfaction, it is recommended only after all nonsurgical measures have been exhausted. The
most common complications of release surgery include incomplete relief of pain and nerve damage.
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.