What is Plantar Fasciitis?
Plantar Fasciitis is a condition that causes pain and inflammation in the plantar fascia, a thick ligament on the bottom of the foot that connects the heel bone with the base of the toes. The plantar fascia is a ligament that has characteristics similar to a tendon, with a limited blood and nerve supply.
The plantar fascia plays a major role in foot mechanics and constantly stretches or contracts depending on your movement. When you stand, your arch drops, stretching and lengthening the foot which means the fascia is elongated and tightened. When your foot is not in contact with the floor, your arch is at maximal height and the fascia is shorter. It also plays an important part in the gait cycle when walking or running. When you push off, the toes flex back which causes the fascia to tighten and raises the arch to stabilize the foot for propulsion.
Plantar Fasciitis Symptoms
- The most common plantar fasciitis pain occurs on the bottom of the heel. This usually happens after a prolonged period of rest, when you first stand. Most experience this pain first thing in the morning after they get out of bed. This pain usually improves initially, however worsens throughout the day with increased activity.
- Neuritis or nerve pain in the heel area. Nerve branches under the fascia can become irritated causing burning pain that radiates around the heel and travels up the leg.
- Periostitis of the heel bone. Inflammation of the tissue enveloping the heel bone may occur as a result of repetitive stress and direct trauma to the area.
What Causes Plantar Fasciitis?
The plantar fascia is complex and usually there are multiple causes for plantar fasciitis.
- When movement in the gait cycle malfunctions, the fascia can be overworked and stretched which can lead to micro tears, structural damage & pain. An induvial with a big toe that doesn’t flex properly, prevents a proper “push off” which can damage the fascia. Big toe joint dysfunction can occur from damage to the joint from arthritis or from over pronation where the arch flattens on stance jamming the joint.
- Weight gain can put physical stress on the foot. The fascia works to stabilize the foot and needs to work harder due to the excess weight.
- Fat pad atrophy occurs as one ages causing pain in the heel area. During overpronation, the arch drops, lengthening the foot and stretching the fascia. The fascia is overworked causing it micro trauma and pain.
- Physical activities characterized by repetitive motion can increase stress on the heel and tissue.
- Inappropriate footwear. Shoes that are poorly constructed or worn out can sometimes cause a person to develop plantar fasciitis.
Treatment of Plantar Fasciitis
For the most part, plantar fasciitis will resolve on its own, typically within a year. It is important to note that the correct treatment will help speed up the process. The sooner you seek out medical help, the sooner you will improve.
Shoes. Plantar Fasciitis shoes are designed with a solid heel counter to control motion, a sturdy outsole, and additional motion control features.
Not only does the shoe need to be appropriate, it also needs to fit correctly! Shoes that are too tight or too short will exacerbate the condition.
A wide last and extra depth are key to providing unrestricted toe movement and a pressure free environment. Plantar fasciitis footwear should feature orthotic insoles to support the arch, prevent excessive pronation and help alleviate strain on the plantar fascia.
- Insole and Foot Orthotics. Plantar Fasciitis insoles cradle the heel, provide cushioning and anatomically support the arch. They prevent the foot from pronating and improve big toe joint function. Advance orthotics even mold to the specific shape of the foot with time, providing additional customized comfort.
- Oral steroids such as prednisone or non-steroids pain relivers such as ibuprofen may also help alleviate pain.
- Cortisone injections can be administered if shoes and orthotics do not offer much improvement. When the injections are administered together with the shoes and orthotics, the success rate is higher.
- In more complex cases, an immobilizing boot worn with plantar fasciitis insoles worn 24 hours a day for a few weeks can help.
- Surgery or shock wave treatment is a last treatment resort.