Plantar Fasciitis

Plantar Fasciitis is an inflammatory condition involving the plantar fascia, a thick band of connective tissue on the bottom of the foot. This thick band of tissue extends from the heel to the ball of the foot and helps in support and stabilization of the foot (especially the arch) during walking and running.

Symptoms involve two areas: the arch and more commonly, the under heel area. Severe pain can be present, typically in the morning on arising and after periods of rest. This pain usually decreases somewhat with initial mobility and then, as the day progresses, can become quite painful, depending on the activity level. Swelling, redness and heat are usually not apparent. Many patients use the term ‘stone bruise’ to describe this condition.

The most common cause of plantar faciitis is overuse, an excessive amount of activity over a given period of time. This excessive activity causes a stretching or pulling force on the heel area, resulting in a fatigue failure and breakdown of the facial tissue. Over a period of time, this traction, or pulling force, can result in heel spur formation which can be clearly seen on x-rays. Certain generalized arthritic problems can also be responsible for plantarfaciitis/heelspura syndrome.

Treatment initially consists of:

• Icing
• Supportive/Stable shoes/Soft insoles
• Stretching exercises to stretch the Achilles Tendon and plantar fascia. This should be one in the morning or before activity.
• The use of oral anti-inflammatory agents (Advil, Nuprin or aspirin)
  Eight to Twelve week is usually the amount of time necessary for symptoms to improve significantly. In resistant cases the following may be necessary to obtain a cure:
• Custom orthotics
• Local anesthetic steroid injections
• Nightsplint
• Physical therapy
• Surgery
•  

Recommendations

Icing for 20 minutes twice a day.

Stretching exercises (as demonstrated below) twice daily

Stretching Exercises

• Stretch and hold for 1 minute
• Repeat each stretch three times