Plantar fasciitis is one of the most common causes of heel pain. It involves pain and inflammation of a thick band of tissue, called the plantar fascia, that runs across the bottom of your foot and
connects your heel bone to your toes. Plantar fasciitis commonly causes stabbing pain that usually occurs with your very first steps in the morning. Once your foot limbers up, the pain of plantar
fasciitis normally decreases, but it may return after long periods of standing or after getting up from a seated position. Plantar fasciitis is particularly common in runners. In addition, people who
are overweight and those who wear shoes with inadequate support are at risk of plantar fasciitis.
Plantar fasciitis is a painful disorder in the lower part of your foot usually around the heel. That pain usually hurts as you get up in the morning when you try to stand on your feet, or after any
periods of inactivity. It is a disorder of a tough and strong band that connects the heel bone to the toes. Plantar Fasciitis is caused by injuring that tough band on the bottom of the foot. The
following may be the causes of plantar fasciitis. Tight calf muscles or tight Achilles tendon produces repetitive over-stretching of the plantar fascia. Gait and balance Problem may be a dominant
cause of this disorder. Many people have a special style of walking, with something unique that causes some kind of imbalance in their body. It might be something like locked knees, feet that
turn-out, a weak abdomen etc. This imbalance may place some pressure on the fascia, which eventually causes plantar fasciitis. Weak foot muscles donât give enough support to the plantar fascia. The
small muscles in the foot give the foot its shape by keeping the bones in place and by expanding and contracting to make a movement. Weak foot muscles will allow greater stress on the fascia. Foot
anatomical problems such as flat feet or high arches can make the fascia ligament work or stretch abnormally. Flattening of the fat pad at the sole of the feet under the heels is a Degeneration
process that is caused by poor footwear or by age. Shoes that have no proper heel cup can flatten that fat pad quite quickly and cause this disorder. Walking in shoes which do not have good arch
support is considered to be a cause of plantar fasciitis. Wearing inadequate or worn out shoes may place more stress on the fascia ligament. If you wear shoes that don't fit you by size or width, you
may put your feet under excessive stress. Overweight Men and women are more vulnerable to developing the condition because of the excess weight on the foot. Pregnant women are at risk due to gaining
weight through pregnancy and due to the pregnancy hormones that make ligaments loosen and relax. Sudden increase of activity like starting to run long distance or complete change of daily activity
can cause heel pain and this disorder. Practice of repetitive athletic activities, like long distance running, playing a ball game, dancing or jumping, is a common cause for the disorder. Actually it
is considered as one of the most common running injuries. Spending long periods of time on your feet everyday can cause plantar fasciitis. Working on your feet a few hours a day evey day may be the
reason for your heel pain.
Heel pain is the most common symptom associated with plantar fasciosis. Your heel pain may be worse in the morning or after you have been sitting or standing for long periods. Pain is most common
under your heel bone, but you also may experience pain in your foot arch or on the outside aspect of your foot. Other common signs and symptoms of plantar fasciosis include mild swelling and redness
in your affected area, tenderness on the bottom of your heel, impaired ability to ambulate.
After you describe your symptoms and discuss your concerns, your doctor will examine your foot. Your doctor will look for these signs. A high arch, an area of maximum tenderness on the bottom of your
foot, just in front of your heel bone. Pain that gets worse when you flex your foot and the doctor pushes on the plantar fascia. The pain improves when you point your toes down. Limited "up" motion
of your ankle. Your doctor may order imaging tests to help make sure your heel pain is caused by plantar fasciitis and not another problem. X-rays provide clear images of bones. They are useful in
ruling out other causes of heel pain, such as fractures or arthritis. Heel spurs can be seen on an x-ray. Other imaging tests, such as magnetic resonance imaging (MRI) and ultrasound, are not
routinely used to diagnose plantar fasciitis. They are rarely ordered. An MRI scan may be used if the heel pain is not relieved by initial treatment methods.
Non Surgical Treatment
Treatment initially involves offloading the plantar fascia by aoiding aggravating factors, such as running. Taping, this can work very well to alleviate pain, and can be almost immediate. It isn't a
long-term solution, but can relieve symptoms in the beginning. Using a night splint to stretch the calf, so that less load is placed on the plantar fascia (if tightness in the calf is a factor).
Using a gel heel cup, this can act to increase shock absorption, and by raising the heel there is also less stretch on the calf. So, temporarily, this may relieve pain in someone who has a tight
calf. Massage, but this depends if the plantarfascia is actually tight or just painful. If it is tight, then massage can temporarily relieve the pain, but if it is irritated then taping and
corrective footwear is preferable.
The majority of patients, about 90%, will respond to appropriate non-operative treatment measures over a period of 3-6 months. Surgery is a treatment option for patients with persistent symptoms, but
is NOT recommended unless a patient has failed a minimum of 6-9 months of appropriate non-operative treatment. There are a number of reasons why surgery is not immediately entertained including.
Non-operative treatment when performed appropriately has a high rate of success. Recovery from any foot surgery often takes longer than patients expect. Complications following this type of surgery
can and DO occur! The surgery often does not fully address the underlying reason why the condition occurred therefore the surgery may not be completely effective. Prior to surgical intervention, it
is important that the treating physician ensure that the correct diagnosis has been made. This seems self-evident, but there are other potential causes of heel pain. Surgical intervention may include
extracorporeal shock wave therapy or endoscopic or open partial plantar fasciectomy.