Plantar fasciitis is a common and often persistent kind of repetitive strain injury afflicting runners, walkers and hikers, and nearly anyone who stands for a living - cashiers, for instance. It
causes mainly foot arch pain and/or heel pain. Morning foot pain is a signature symptom. Plantar fasciitis is not the same thing as heel spurs and flat feet, but they are related and often confused.
Most people recover from plantar fasciitis with a little rest, arch support (regular shoe inserts or just comfy shoes), and stretching, but not everyone. Severe cases can stop you in your tracks,
undermine your fitness and general health, and drag on for years. This tutorial is mostly for you: the patient with nasty chronic plantar fasciitis that just wonât go away.
Plantar fasciitis is the most common injury of the plantar fascia and is the most common cause of heel pain. Approximately 10% of people have plantar fasciitis at some point during their lifetime. It
is commonly associated with long periods of standing and is much more prevalent in individuals with excessive inward rolling of the foot, which is seen with flat feet. Among non-athletic populations,
plantar fasciitis is associated with obesity and lack of physical exercise.
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.
Plantar fasciitis is usually diagnosed by your physiotherapist or sports doctor based on your symptoms, history and clinical examination. After confirming your plantar fasciitis they will investigate
WHY you are likely to be predisposed to plantar fasciitis and develop a treatment plan to decrease your chance of future bouts. X-rays may show calcification within the plantar fascia or at its
insertion into the calcaneus, which is known as a calcaneal or heel spur. Ultrasound scans and MRI are used to identify any plantar fasciitis tears, inflammation or calcification. Pathology tests
(including screening for HLA B27 antigen) may identify spondyloarthritis, which can cause symptoms similar to plantar fasciitis.
Non Surgical Treatment
If you protect your injured plantar fascia appropriately the injured tissues will heal. Inflammed structures will settle when protected from additional damage, which can help you avoid long-standing
degenerative changes. Plantar fasciitis may take from several weeks (through to many months) to heal while we await Mother Nature to form and mature the new scar tissue, which takes at least six
weeks. During this time period you should be aiming to optimally remould your scar tissue to prevent a poorly formed scar that may become lumpy or potentially re-tear in the future. It is important
to lengthen and orientate your healing scar tissue via massage, gentle stretches, and light active exercises. In most cases, your physiotherapist will identify stiff joints within your foot and ankle
complex that they will need to loosen to help you avoid plantar fascia overstress.A sign that you may have a stiff ankle joint can be a limited range of ankle bend during a squat manoeuvre. Your
physiotherapist will guide you.
When more-conservative measures aren't working, your doctor might recommend steroid shots. Injecting a type of steroid medication into the tender area can provide temporary pain relief. Multiple
injections aren't recommended because they can weaken your plantar fascia and possibly cause it to rupture, as well as shrink the fat pad covering your heel bone. Extracorporeal shock wave therapy.
In this procedure, sound waves are directed at the area of heel pain to stimulate healing. It's usually used for chronic plantar fasciitis that hasn't responded to more-conservative treatments. This
procedure may cause bruises, swelling, pain, numbness or tingling and has not been shown to be consistently effective. Surgery. Few people need surgery to detach the plantar fascia from the heel
bone. It's generally an option only when the pain is severe and all else fails. Side effects include a weakening of the arch in your foot.
Being overweight can place excess pressure and strain on your feet, particularly on your heels. Losing weight, and maintaining a healthy weight by combining regular exercise with a healthy, balanced
diet, can be beneficial for your feet. Wearing appropriate footwear is also important. Ideally, you should wear shoes with a low to moderate heel that supports and cushions your arches and heels.
Avoid wearing shoes with no heels.