Plantar Fasciitis is a chronic pain in the heel that can just appear from nowhere but it is actually a long standing mechanical condition caused by prolonged stress on your foot. In most cases
Plantar Fasciitis is a common, but very treatable, mechanical condition of the foot and responds positively to orthotics. A heel pain caused by prolonged stress on a ligament like structure in the
arch that is very important in weigh-bearing activities. The tissue becomes damaged and needs to be helped to repair in order for the pain to go or subside to a manageable level. Orthotics for your
feet can achieve this necessary healing for pain relief. It can be very painful, and even debilitating for sufferers.
Plantar fasciitis is usually not the result of a single event but more commonly the result of a history of repetitive micro trauma combined with a biomechanical deficiency of the foot. Arthritic
changes and metabolic factors may also playa part in this injury but are unlikely in a young athletic population. The final cause of plantar fasciitis is "training errors." In all likelihood the
injury is the result of a combination of biomechanical deficiencies and training errors. Training errors are responsible for up to 60% of all athletic injuries (Ambrosius 1992). The most frequent
training error seen with plantar fasciitis is a rapid increase in volume (miles or time run) or intensity (pace and/or decreased recovery). Training on improper surfaces, a highly crowned road,
excessive track work in spiked shoes, plyometrics on hard runways or steep hill running, can compromise the plantar fascia past elastic limits. A final training error seen in athletics is with a
rapid return to some preconceived fitness level. Remembering what one did "last season" while forgetting the necessity of preparatory work is part of the recipe for injury. Metabolic and arthritic
changes are a less likely cause of plantar fasciitis among athletes. Bilateral foot pain may indicate a metabolic or systemic problem. The definitive diagnosis in this case is done by a professional
with blood tests and possibly x-rays.
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
As with most soft tissue injuries the initial treatment is Rest, Ice, and Protection. In the early phase youâll most likely be unable to walk pain-free. Our first aim is to provide you with some
active rest from pain-provoking foot postures. This means that you should stop doing any movement or activity that provoked your foot pain in the first place. Ice is a simple and effective modality
to reduce your pain and swelling. Please apply for 20-30 minutes each 2 to 4 hours during the initial phase or when you notice that your injury is warm or hot. A frozen water bottle can provide you
with a ice foot roller that can simultaneously provide you with some gentle plantar fascia massage. Anti-inflammatory medication (if tolerated) and natural substances eg arnica may help reduce your
pain and swelling. However, it is best to avoid anti-inflammatory drugs during the initial 48 to 72 hours when they may encourage additional bleeding. Most people can tolerate paracetamol as a pain
reducing medication. To support and protect your plantar fascia, you may need to be wear a plantar fascia brace, heel cups or have your foot taped to provide pain relief. As mentioned earlier, the
cause of your plantar fasciitis will determine what works best for you. Your physiotherapist will guide you. Your physiotherapist will guide you and utilise a range of pain relieving techniques
including joint mobilisations for stiff joints, massage, electrotherapy, acupuncture or dry needling to assist you during this pain-full phase.
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.
To reduce your risk of getting plantar fasciitis take these steps. Wear appropriate and well-fitted footwear during sports and exercise. Do stretching exercises for the Achilles tendon and plantar
fascia. Increase the intensity and duration of exercise gradually. Maintain an appropriate weight.