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.
Factors which may contribute to plantar fasciitis and heel spurs include a sudden increase in daily activities, increase in weight (not usually a problem with runners), or a change of shoes. Dramatic
increase in training intensity or duration may cause plantar fasciitis. Shoes that are too flexible in the middle of the arch or shoes that bend before the toe joints will cause an increase in
tension in the plantar fascia. Even though you may have run in shoes that are flexible before, now that you have developed plantar fasciitis, make certain that your shoe is stable and does not bend
in the midfoot. Check and be certain that your shoes are not excessively worn. Shoes that do not sufficiently control excessive pronation combined with an increase in training can lead to this
condition. A change in running style or parameters, such as starting speed work, running on the ball of your foot or sudden increase in hill workouts may lead to problems. All changes should be
gradual and not abrupt. Gait changes such as altering your foot strike, switching shoe style, running barefoot or in minimalist shoes should all be made gradually and not abruptly. The "terrible
too's" of too much, too soon, too often with too little rest also applies to "too many changes with too little adaptation". Make your changes gradually and allow your muscles, bones, and other body
structures to adapt to the alterations you may be attempting.
The main symptom of plantar fasciitis is heel pain when you walk. You may also feel pain when you stand and possibly even when you are resting. This pain typically occurs first thing in the morning
after you get out of bed, when your foot is placed flat on the floor. The pain occurs because you are stretching the plantar fascia. The pain usually lessens with more walking, but you may have it
again after periods of rest. You may feel no pain when you are sleeping because the position of your feet during rest allows the fascia to shorten and relax.
Your GP or podiatrist (a healthcare professional who specialises in foot care) may be able to diagnose the cause of your heel pain by asking about your symptoms and examining your heel and foot. You
will usually only need further tests if you have additional symptoms that suggest the cause of your heel pain is not inflammation, such as numbness or a tingling sensation in your foot, this could be
a sign of nerve damage in your feet and legs (peripheral neuropathy) your foot feels hot and you have a high temperature (fever) of 38C (100.4F) or above - these could be signs of a bone infection,
you have stiffness and swelling in your heel, this could be a sign of arthritis. Possible further tests may include blood tests, X-rays - where small doses of radiation are used to detect problems
with your bones and tissues, a magnetic resonance imaging (MRI) scan or ultrasound scan, which are more detailed scans.
Non Surgical Treatment
Over-the-counter Orthotics. A soft, over-the-counter orthotic (Prefabricated orthotic) with an accommodating arch support has proven to be quite helpful in the management of plantar fascia symptoms.
Studies demonstrate that it is NOT necessary to obtain a custom orthotic for the treatment of this problem. Comfort Shoes. Shoes with a stiff sole, rocker-bottom contour, and a comfortable leather
upper combined with an over-the-counter orthotic or a padded heel can be very helpful in the treatment of plantar fasciitis. Anti-Inflammatory Medication (NSAIDs): A short course of over-the-counter
anti-inflammatory medications may be helpful in managing plantar fasciitis symptoms providing the patient does not have any contra-indications such as a history of stomach ulcers. Activity
Modification Any activity that has recently been started, such as a new running routine or a new exercise at the gym that may have increased loading through the heel area, should be stopped on a
temporary basis until the symptoms have resolved. At that point, these activities can be gradually started again. Also, any activity changes (ex. sitting more) that will limit the amount of time a
patient is on their feet each day may be helpful. A night splint, which keeps the ankle in a neutral position (right angle) while the patient sleeps, can be very helpful in alleviating the
significant morning symptoms. A night splint may be prescribed by your physician. Alternatively, it can be ordered online or even obtained in some medical supply stores. This splint is worn nightly
for 1-3 weeks until the cycle of pain is broken. Furthermore, this splinting can be reinstituted for a short period of time is symptoms recur.
Surgery for plantar fasciitis can be very successful in the right patients. While there are potential complications, about 70-80% of patients will find relief after plantar fascia release surgery.
This may not be perfect, but if plantar fasciitis has been slowing you down for a year or more, it may well be worth these potential risks of surgery. New surgical techniques allow surgery to release
the plantar fascia to be performed through small incisions using a tiny camera to locate and cut the plantar fascia. This procedure is called an endoscopic plantar fascia release. Some surgeons are
concerned that the endoscopic plantar fascia release procedure increases the risk of damage to the small nerves of the foot. While there is no definitive answer that this endoscopic plantar fascia
release is better or worse than a traditional plantar fascia release, most surgeons still prefer the traditional approach.
While it's typical to experience pain in just one foot, massage and stretch both feet. Do it first thing in the morning, and three times during the day. Achilles Tendon Stretch. Stand with your
affected foot behind your healthy one. Point the toes of the back foot toward the heel of the front foot, and lean into a wall. Bend the front knee and keep the back knee straight, heel firmly
planted on the floor. Hold for a count of 10. Plantar Fascia Stretch. Sit down, and place the affected foot across your knee. Using the hand on your affected side, pull your toes back toward your
shin until you feel a stretch in your arch. Run your thumb along your foot--you should feel tension. Hold for a count of 10.