The plantar fascia is a ligament that connects the heel to the toes on the bottom of the foot. It lies just below the skin layers as it passes over the arch of the foot. A common ailment called plantar fasciitis is the result of this ligament becomes inflamed. This can Foot anatomyhappen from injury, physical stress, or sometimes for no obvious reason. The most common point for this inflammation is where this ligament joints the heel bone. Typical symptoms are the pain on the bottom of the foot near the heel usually most intense in the mornings when arising or after a long period with little movement. The pain typically diminishes with movement. Many suffering from plantar fasciitis have heel spurs. Even though they are in the same area they are unrelated and the heel spurs do not cause the plantar fasciitis. Most times heel spurs will not cause pain and in many go undetected unless they have an x-ray for some other reason.
There are multiple potential causes and contributing factors to plantar fasciitis heel pain. The structure of a person’s foot and the way that they walk or run usually play a significant role in the development of plantar fasciitis. Those with an arch that is lower or higher than the average person are more likely to be afflicted. Overexertion and/or participating in activities that a person is not accustomed to also place a person at risk. This can include a heavy workout, a job change, or even an extended shopping trip. Additionally, inappropriate shoes are also often a factor. Exercising in shoes that are worn out or don’t have enough support and/or wearing inexpensive, flimsy or flat-soled dress or casual shoes are common culprits. In warm climates, such as here in Southern California, people who wear flip-flop sandals or even go barefoot throughout the year increase their chances of developing heel pain. Many athletes and weekend warriors develop heel or arch pain from over-exertion during running or other sports. People who work at jobs that involve long periods of standing, such as grocery checkers, cashiers, warehouse workers, postal workers, and teachers are more susceptible as well. Adults of all ages can develop plantar fasciitis. Heel pain in children is usually caused by a different type of condition.
Patients with plantar fasciitis typically experience pain underneath the heel and along the inner sole of the foot. In less severe cases, patients may only experience an ache or stiffness in the plantar fascia or heel that increases with rest (typically at night or first thing in the morning) following activities which place stress on the plantar fascia. These activities typically include standing, walking or running excessively (especially up hills, on uneven surfaces or in poor footwear such as thongs), jumping, hopping and general weight bearing activity. The pain associated with this condition may also warm up with activity in the initial stages of injury. As the condition progresses, patients may experience symptoms that increase during sport or activity, affecting performance. In severe cases, patients may walk with a limp or be unable to weight bear on the affected leg. Patients with this condition may also experience swelling, tenderness on firmly touching the plantar fascia (often on a specific spot on the inner aspect of the heel) and sometimes pain on performing a plantar fascia stretch.
Your doctor may look at your feet and watch the way you stand, walk and exercise. He can also ask you questions about your health history, including illnesses and injuries that you had in your past. The symptoms you have such as the pain location or when does your foot hurts most. Your activity routine such as your job, exercise habits and physical activities preformed. Your doctor may decide to use an X-ray of your foot to detect bones problems. MRI or ultrasound can also be used as further investigation of the foot condition.
Non Surgical Treatment
Treatments you can do at home include rest. Try to avoid activities that put stress on your feet. This can be hard, especially if your job involves being on your feet for hours at a time, but giving your feet as much rest as possible is the first step in reducing the pain of plantar fasciitis. Use ice or a cold compress to reduce pain and inflammation. Do this three or four times a day for about 20 minutes at a time until the pain goes away. Take anti-inflammatory medications. Painkillers such as ibuprofen or acetaminophen can help relieve pain and reduce inflammation in the affected area. Your doctor may also prescribe a medication called a corticosteroid to help treat severe pain. Exercise your feet and calves. When the pain is gone, do calf and foot stretches and leg exercises to make your legs as strong and flexible as possible. This can help you avoid getting plantar fasciitis again. Ask your coach, athletic trainer, or a physical therapist to show you some leg exercises. Rolling a tennis ball under your foot can massage the area and help the injury heal. Talk to your doctor about shoe inserts or night splints. Shoe inserts can give your feet added support to aid in the healing process. Night splints keep your calf muscles gently flexed, helping to keep your plantar fascia from tightening up overnight. Have a trainer or sports injury professional show you how to tape your foot. A proper taping job allows your plantar fascia to get more rest. You should tape your foot each time you exercise until the pain is completely gone. For people who get repeated sports injuries, it can help to see a sports medicine specialist. These experts are trained in evaluating things like an athlete’s running style, jumping stance, or other key moves. They can teach you how to make the most of your body’s strengths and compensate for any weaknesses. Once you’re healed, look for the silver lining in your bench time. You may find that what you learn from having an injury leads you to play a better game than ever before.
In unusual cases, surgical intervention is necessary for relief of pain. These should only be employed after non-surgical efforts have been used without relief. Generally, such surgical procedures may be completed on an outpatient basis in less than one hour, using local anesthesia or minimal sedation administrated by a trained anesthesiologist. In such cases, the surgeon may remove or release the injured and inflamed fascia, after a small incision is made in the heel. A surgical procedure may also be undertaken to remove bone spurs, sometimes as part of the same surgery addressing the damaged tissue. A cast may be used to immobilize the foot following surgery and crutches provided in order to allow greater mobility while keeping weight off the recovering foot during healing. After removal of the cast, several weeks of physical therapy can be used to speed recovery, reduce swelling and restore flexibility.