So, one morning while taking your first step out of bed you experience severe pain of your heel. It takes about 10 minutes for the pain to subside. This scenario repeats itself every time you sit and then stand up again. These are the classic symptoms of plantar fasciitis.
The plantar fascia is a flat ligament like structure in your arch that separates your skin from the muscles of your foot. It runs from your heel bone to the balls of your feet. Its original design was to protect the muscles of your foot from being damaged when our ancestors once walked barefooted. We have a similar ligament in the palms of our hands known as the palmar fascia. This is also a protective structure for our hands. In addition, the plantar fascia also acts to raise your arch when your heel leaves the ground while walking. Plantar fasciitis is caused by the minute tearing of the plantar fascia. This tearing can be the result of trauma or from poor foot biomechanics. This tearing usually occurs were the fascia attaches to the heel bone thus causing heel pain. The repeated tearing and healing of this ligament will cause bone spurs to form thus causing what is known as heel spur syndrome.
Plantar fasciitis can occur for several reasons which all cause the plantar fascia to over stretch or tear. The first being an excessive amount of weight gain over a relatively short period of time. The second is caused by walking or running without proper support in the arch. People that decide to suddenly exercise after being sedentary or “weekend warrior syndrome” often develop this problem. The third reason is trauma or injury from a hard object pressing into the arch or heel or from jumping from a height. The majority of patients that suffer from plantar fasciitis have some type of biomechanical imbalance often combined with flat feet or high arch feet. With either foot type, it is usually the excessive turning in of the ankle/foot (pronation) that most patients with this problem share in common.
The most common symptom is pain located on the bottom and inside of the heel. The pain is most noticeable when first stepping out of bed in the morning or when stepping down after long periods of sitting. Pain usually improves after several steps.
Your Podiatrist will perform a thorough examination including detailed history, visual exam, biomechanical exam and gait analysis (evaluating the way you walk). X-rays may also be taken.
Initial treatment usually involves stretching exercises. Your Podiatrist may order Physical Therapy for faster results. Strapping or taping of the arch for added support. Cortisone injections are usually given once weekly (usually 3-5 injections). These injections when done properly are not as bad as they sound. This relieves the inflammation caused by the tearing of the plantar fascia. By far the most important part of treatment is arch support preferably in the form of orthotics. Foot orthotics are custom molded devices that correct biomechanical imbalances of the foot and relieve the stretching of the plantar fascia. These devices can be made to fit many types of shoes and are strongly suggested for the athlete. Finally, if all other conservative care has failed, surgical intervention may be considered although if treated early this is rarely necessary.
CALL OUR OFFICE IF:
You experience heel pain or if you feel you are at risk for developing heel pain.