Plantar fasciitis is a dull to severe pain in your heel caused by a strain and inflammation of your plantar fascia. The plantar fascia is a scientific name for âfoot tissueâ. This particular
tissue is a ligament attached at one side to the heel bone. At the other side, the tissue fans out to attach at the base of each of your five toes. Plantar fasciitis is the name for the condition
that develops when that tissue becomes inflamed. When the plantar fascia is excessively stretched, micro-tears can occur, causing this swelling and subsequent pain.
Patients with tight calf muscles will suffer with excessive pulling of the muscle group on the back of the heel. This in turn creates pulling of other structures that are attached to the heel,
including the Plantar Fascia. When the pulling continues for long enough, then inflammation will develop and lead to Plantar Fasciitis. This causes Heel Pain. It is extremely common for patients who
increase their level of activity to develop Plantar Fasciitis. Boot camp, running, zumba, recreational walking or other quick movement sports such as tennis or touch football are typical causes of
Heel Pain. The sharp increase in exercise is too much for the foot to cope with and the stress on the Plantar Fascia causes inflammation. The Heel Pain that is caused by this inflammation is known as
Most people with plantar fasciitis have pain when they take their first steps after they get out of bed or sit for a long time. You may have less stiffness and pain after you take a few steps. But
your foot may hurt more as the day goes on. It may hurt the most when you climb stairs or after you stand for a long time. If you have foot pain at night, you may have a different problem, such as
arthritis , or a nerve problem such as tarsal tunnel syndrome.
During the physical exam, your doctor checks for points of tenderness in your foot. The location of your pain can help determine its cause. Usually no tests are necessary. The diagnosis is made based
on the history and physical examination. Occasionally your doctor may suggest an X-ray or magnetic resonance imaging (MRI) to make sure your pain isn't being caused by another problem, such as a
stress fracture or a pinched nerve. Sometimes an X-ray shows a spur of bone projecting forward from the heel bone. In the past, these bone spurs were often blamed for heel pain and removed
surgically. But many people who have bone spurs on their heels have no heel pain.
Non Surgical Treatment
In general, plantar fasciitis is a self-limiting condition. Unfortunately, the time until resolution is often six to 18 months, which can lead to frustration for patients and physicians. Rest was
cited by 25 percent of patients with plantar fasciitis in one study as the treatment that worked best. Athletes, active adults and persons whose occupations require lots of walking may not be
compliant if instructed to stop all activity. Many sports medicine physicians have found that outlining a plan of ârelative restâ that substitutes alternative forms of activity for activities
that aggravate the symptoms will increase the chance of compliance with the treatment plan. It is equally important to correct the problems that place individuals at risk for plantar fasciitis, such
as increased amount of weight-bearing activity, increased intensity of activity, hard walking/running surfaces and worn shoes. Early recognition and treatment usually lead to a shorter course of
treatment as well as increased probability of success with conservative treatment measures.
In very rare cases plantar fascia surgery is suggested, as a last resort. In this case the surgeon makes an incision into the ligament, partially cutting the plantar fascia to release it. If a heel
spur is present, the surgeon will remove it. Plantar Fasciitis surgery should always be considered the last resort when all the conventional treatment methods have failed to succeed. Endoscopic
plantar fasciotomy (EPF) is a form of surgery whereby two incisions are made around the heel and the ligament is being detached from the heel bone allowing the new ligament to develop in the same
place. In some cases the surgeon may decide to remove the heel spur itself, if present. Just like any type of surgery, Plantar Fascia surgery comes with certain risks and side effects. For example,
the arch of the foot may drop and become weak. Wearing an arch support after surgery is therefore recommended. Heel spur surgeries may also do some damage to veins and arteries of your foot that
allow blood supply in the area. This will increase the time of recovery.
Calf stretch. Lean forward against a wall with one knee straight and the heel on the ground. Place the other leg in front, with the knee bent. To stretch the calf muscles and the heel cord, push your
hips toward the wall in a controlled fashion. Hold the position for 10 seconds and relax. Repeat this exercise 20 times for each foot. A strong pull in the calf should be felt during the stretch.
Plantar fascia stretch. This stretch is performed in the seated position. Cross your affected foot over the knee of your other leg. Grasp the toes of your painful foot and slowly pull them toward you
in a controlled fashion. If it is difficult to reach your foot, wrap a towel around your big toe to help pull your toes toward you. Place your other hand along the plantar fascia. The fascia should
feel like a tight band along the bottom of your foot when stretched. Hold the stretch for 10 seconds. Repeat it 20 times for each foot. This exercise is best done in the morning before standing or