Plantar Fasciitis
Overview
Plantar fasciitis is a common foot condition characterized by inflammation of the plantar fascia, a thick band of tissue that runs across the bottom of your foot and connects your heel bone to your toes. The plantar fascia supports the arch of your foot and helps you walk by absorbing shock as you move. Simple physical exercises or night splints can stretch the Achilles tendon, plantar fasciitis, or calf muscles. Plantar fasciitis is commonly thought to be caused by a heel spur.
What is Heel Spurs?
Heel spurs are bony protrusions that form on the underside of the heel bone, often causing pain and discomfort during weight-bearing activities like walking or running. However, bone spurs in the foot do not cause plantar fasciitis pain. Most individuals don’t feel pain in case of a heel spur. A heel spur can be the result of standing for long. Besides, you can treat a heel spur the same way you treat plantar fasciitis.
Causes
Plantar fasciitis is primarily caused by repetitive strain and excessive stress on the plantar fascia, resulting in inflammation and micro-tears. Common causes include:
Overuse
Activities that repeatedly stress the heel and arch, such as running, dancing, or standing for prolonged periods. usually, plantar fasciitis occurs due to overstretching or overuse of the thick band of tissue. children or adults may develop plantar fasciitis from overuse of the ligament or wearing old shoes.
Foot Mechanics
Flat feet, high arches, or abnormal walking patterns (gait abnormalities) can place excessive strain on the plantar fascia.
Age and Weight
Middle-aged individuals and those who are overweight or obese are more prone to developing plantar fasciitis due to increased pressure on the feet.
Footwear
Wearing shoes with inadequate support or cushioning, or sudden changes in footwear that do not provide proper arch support, can contribute to the development of plantar fasciitis.
People, who are overweight can also have chronic plantar fasciitis. These factors can individually or collectively lead to irritation, inflammation, and pain in the plantar fascia, resulting in the symptoms characteristic of plantar fasciitis.
Symptoms
Symptoms of plantar fasciitis include:
Heel Pain
Typically, the most prominent symptom is plantar chronic heel pain which is usually sharp and stabbing. It primarily affects the underside or the front of the heel bone and may extend along the arch of the foot.
Pain in the Morning
Pain is often most severe with the first steps in the morning or after periods of rest, such as after sitting or lying down for a while. This is due to the tightening of the plantar fascia overnight.
Pain with Activity
Stabbing Pain may diminish as the day progresses with movement, but it can return after long periods of standing or walking.
Stiffness
The bottom of the foot may feel stiff and tight, especially after prolonged periods of inactivity.
Tenderness
The affected area, usually near the heel, may be tender to the touch.
Heel Bone Discomfort after Exercise
Foot Pain and discomfort may worsen after activities that stress the plantar fascia, such as running, walking long distances, or climbing stairs.
If you witness these symptoms of plantar fasciitis, consult your physical therapist. They will recommend different exercises.
Risk Factors of Plantar Fasciitis
Plantar fasciitis, the inflammation of the plantar fascia (the thick band of tissue that connects your heel bone to your toes), can have several risk factors. These include:
Overuse or Overloading: Engaging in activities that place excessive stress on the plantar fascia, such as running long distances, jumping activities, or standing for prolonged periods, can increase the risk.
Age: Plantar fasciitis is more common in middle-aged individuals, typically between the ages of 40 and 60, although it can affect people of all ages.
Foot Mechanics: Flat feet (pes planus) or high arches (pes cavus) can alter the distribution of weight on the foot, increasing the strain on the plantar fascia and leading to inflammation.
Improper Footwear: Wearing shoes with inadequate support or poor cushioning, or suddenly switching to shoes with different support or heel height, can contribute to plantar fasciitis.
Occupation or Activities: Jobs or activities that involve prolonged standing, walking on hard surfaces, or wearing inadequate footwear can increase the risk.
Obesity: Excess body weight puts additional stress on the plantar fascia and can lead to inflammation.
Tightness or Weakness: Tight calf muscles or Achilles tendons, as well as weak foot muscles, can contribute to imbalances and strain on the plantar fascia.
Biomechanical Factors: Any condition that alters normal foot biomechanics, such as leg length discrepancies, can increase the risk of plantar fasciitis.
Previous Injury: Individuals who have had previous foot or ankle injuries, including ankle sprains or fractures, may be at higher risk due to altered gait patterns or weakened structures.
Certain Activities: Participation in activities that involve repetitive stress on the feet without adequate rest or stretching, such as ballet dancing or long-distance running, can increase the risk.
Diagnosis
Diagnose Plantar fasciitis typically involves a combination of medical history, physical examination, and sometimes imaging studies. Here’s an overview of the diagnostic process:
Medical History
Your doctor will inquire about your symptoms, including the location, onset, and duration of pain. They may ask about your daily activities, exercise routines, footwear, and previous foot structure problems.
Physical Examination
A physical examination will focus on your feet, with the doctor checking for tenderness along the bottom of your foot, particularly near the heel and along the arch. They may also assess your foot mechanics, such as checking for flat feet or high arches, and observe your gait (walking pattern).
Imaging Studies
While not always necessary, imaging tests such as X-rays or ultrasound may be ordered to rule out other causes of heel pain (like fractures or arthritis) and to confirm the diagnosis of plantar fasciitis. X-rays can show if there are any bone spurs or calcifications near the heel, while ultrasound can visualize the thickening or inflammation of the plantar fascia.
Additional Tests
In some cases, other tests such as MRI (Magnetic Resonance Imaging) or ct scan may be used to further evaluate soft tissues and rule out other conditions causing heel pain.
Treatment
Treatment for plantar fasciitis typically involves a combination of conservative measures aimed at reducing pain and inflammation, improving flexibility, and addressing underlying contributing factors. Here are the main plantar fasciitis treatments:
Rest and Activity Modification
Avoid activities that aggravate symptoms, such as prolonged standing or activities that involve repetitive stress on the feet.
Resting the affected foot and allowing time for the inflammation to subside can aid in recovery.
Stretching Exercises
Stretching exercises for the calf muscles and the plantar fascia can help improve flexibility and reduce tension in the affected area. Examples include calf stretches and plantar fascia stretches like towel stretches or using a foam roller. Stretching focus on the plantar fasciitis and the Achilles tendon.
Footwear Modification
Wearing supportive shoes with good arch support and cushioning can help reduce strain on the plantar fascia. Avoid wearing worn-out shoes or shoes with inadequate or poor arch support. Arch supports can pressure evenly across your feet.
Orthotic Devices
Orthotic inserts or shoe inserts (arch supports) can provide additional support and cushioning to the foot. They help distribute pressure evenly and reduce strain on the plantar fascia.
Ice Massage
Massaging the affected area with ice can help reduce inflammation and pain. Use a frozen water bottle or ice pack and roll it under the foot for about 15-20 minutes several times a day.
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
Over-the-counter NSAIDs like ibuprofen or naproxen can help relieve pain and reduce inflammation. Always follow the dosage instructions and consult with a healthcare provider if you have any concerns.
Physical Therapy
A physical therapist can provide specific exercises and techniques to strengthen the calf muscles of the foot and leg, improve flexibility, and correct gait abnormalities that may contribute to plantar fasciitis.
Night Splints
Wearing a night splint can help keep the plantar fascia stretched while sleeping, preventing it from tightening overnight and reducing morning pain. When you wear night splints, it helps you stretch your foot during sleep.
PRP (Platelet-Rich Plasma) Injections
You can get PRP from your blood and inject it into your foot’s plantar fascia to help it heal. PRP injections are safer and don’t increase the risk of the plantar fascia rupture.
Corticosteroid Injections
In cases where conservative treatments do not provide relief, Cortisone injections may be recommended to reduce inflammation and pain. These are typically used sparingly due to potential side effects and are administered by a healthcare professional.
Extracorporeal ShockWave Therapy (ESWT)
This treatment involves using shock waves to stimulate the healing of the plantar fascia. It is used in cases where other treatments have not been effective.
Surgery
Surgery is rarely needed in severe cases of plantar fasciitis and is considered only after conservative treatments have failed to provide relief. Procedures may involve releasing the tension on the plantar fascia rupture or removing heel spurs. Gastrocnemius Recession Surgery is rarely needed for plantar fasciitis but is an option in severe cases.
How to fix plantar fasciitis pain?
To alleviate plantar fasciitis, try stretching exercises and wearing supportive footwear. Consider orthotics or physical therapy for persistent symptoms.
What helps plantar fasciitis?
Plantar fasciitis pain can be eased with stretches targeting the calf and foot. Supportive footwear and orthotics provide relief, while ice and anti-inflammatory medications can reduce heel pain when walking and inflammation. For treating plantar fasciitis, you can also use essential oils. Persistent cases may require physical therapy or corticosteroid injections.
How long does plantar fasciitis last?
Plantar fasciitis can last from a few months to over a year if untreated. Proper management, including rest, exercises, and orthotic support, can hasten recovery. Individual variations and adherence to treatment influence the duration.
What does plantar fasciitis feel like?
Plantar fasciitis typically presents as a sharp heel pain or a dull ache on the bottom of the foot, near the heel. It’s often most intense with the first steps in the morning or after periods of rest. The heel pain may decrease with activity but can worsen after prolonged standing or walking. You can prevent plantar fasciitis with different exercises.
Does plantar fasciitis go away?
Plantar fasciitis can resolve with appropriate treatment and self-care measures. However, it may persist for several months or longer if not managed effectively. Consistent adherence to treatment, including rest, stretching, and orthotic support, improves the likelihood of resolution. However, you can prevent plantar fasciitis by avoiding overuse of your feet.
How do you get plantar fasciitis (plantar fascia)?
Plantar fasciitis often develops due to repetitive strain on the plantar fascia, typically from activities like running, standing for long periods, or wearing improper footwear. Factors like obesity, high arches, flat feet, and tight calf muscles can increase the risk. Poor biomechanics or sudden changes in activity level also contribute.
When To See A Doctor
You should visit a doctor for plantar fasciitis if you experience persistent heel pain that does not improve with rest and home treatments, especially if it interferes with daily activities like walking. Besides, visit medical attention if there’s swelling, redness, or if you have diabetes, as these factors can complicate healing. A doctor can provide a diagnosis, recommend effective treatments, and help prevent long-term complications.
Disclaimer
This information is intended for educational purposes only and should not be considered a substitute for professional medical advice. If you have concerns about plantar fasciitis or any other medical condition, please see a doctor for an accurate plantar fasciitis diagnosis and personalized plantar fasciitis treatment suggestions.
