Plantar Fasciitis


Plantar Fasciitis (Sore Heel)

Plantar Fasciitis is an inflammation of the plantar fascia. The key for proper treatment is determining what is causing the excessive strain and stretching of the plantar fascia. Ask your medical practitioner to find the best solution for your ailment. Often they suggest changing your footwear or using an orthotic as a first step toward recovery.

The Injury

The plantar fascia is a thick fibrous material on the bottom of the foot. It connects to the heel bone (calcaneus), fans forward to the toes and acts like a bowstring to maintain the arch of the foot.

Plantar Fasciitis is a common problem among people who are active in sports, particularly runners. It may also effect people who are on their feet for long periods of time.

Pain may occur when this inflexible fascia is repeatedly placed under tension. This causes an overload that produces an inflammation, usually at the point where the fascia is attached to the heel bone.

It often starts as a dull intermittent pain in the heel, which may progress to a sharp persistent pain. It may be acute either first thing in the morning or after a long rest. This occurs because while you are resting, the plantar fascia contracts back to its original shape. As the day progresses and the plantar fascia is adequately stretched, the pain often subsides.

Since it is difficult to rest the foot, the problem gradually becomes worse because the condition is aggravated with each step. The inflammatory reaction at the heel bone may produce spike-like projections of new bone called heel spurs, and may show on X-rays.  They do not cause the initial problem, they are a result of the problem.

Contributing factors

  • Additional or excessive weight on the foot, from weight gain or pregnancy
  • Wearing shoes with inadequate or improper arch support
  • Flat, over-pronated feet
  • Unusually high, rigid arch
  • Sudden increase in activity
  • “Push off” activities such as running or walking very fast, up hills, or in sand
  • Increasing age
  • Standing on hard surfaces such as concrete for long periods

Treatment

Improvement may take longer than expected, especially if the condition has existed for a long time.  You can reduce the strain and stress on the plantar fascia by following these simple instructions:

  • Rest. If your foot is too painful, rest it.
  • Never go barefoot.
  • Maintain a healthy weight.
  • Ice your heels (or painful area) 2-3 times a day to reduce inflammation.
  • Use an anti-inflammatory medication (ibuprofen, etc.) if approved by your doctor.
  • Wear shoes that support your arch and provide proper shock absorption.
  • Orthotics. (arch supports, heel cups, etc.) may be used to support the arch and cushion the heel. Here at John’s we have found the best orthotic to be one with a firm but slightly flexible arch, such as the Powerstep orthotic.
  • Stretching. The injury is related to both the fascia and calf muscle being tight. Gradual stretching of the calf, Achilles tendon and the bottom of the foot will help lengthen the fascia. Since many people find it difficult to stretch during the day, it may be helpful to use a device that stretches the foot at night, such as the Strassburg Sock.

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