Understanding Plantar Fasciitis

Your plantar fascia is a ligament that connects the front of the foot to the heel and supports the arch of the foot. This ligament absorbs much of the stress that you place on your feet; however, when too much stress is placed on the feet, the plantar fascia can tear or become damaged. This is called plantar fasciitis. When damage occurs in the body, the immune system causes the damaged area to become inflamed as an added layer of protection while the body heals. Unfortunately, this can lead to stiffness of the plantar fascia and heel pain.

There are several things that can increase the risk of developing plantar fasciitis. If you have a high arch or flat feet, suffer from obesity, or if your calf muscles are so tight that it is difficult to flex the foot and pull your toes towards the chest, you are at an increased risk of developing plantar fasciitis. In addition to these risk factors, those who begin a new activity, increase their activity level, or do activities that cause repetitive impact to the feet are increasing the risk of developing plantar fasciitis. Those who spend most of their day standing or walking on hard surfaces (factory worker or teachers) are at an increased risk of developing plantar fasciitis. Finally, those who are between the ages of 40 and 60 often experience plantar fasciitis.

What are the Symptoms of Plantar Fasciitis?

According to the Mayo Clinic, the most common symptoms of plantar fasciitis is stabbing pain in the heel area. Typically, the pain is worse the first thing in the morning or after long periods of sitting or standing still. Exercise can increase the pain level experienced by this condition.

What are the typical Treatments for Plantar Fasciitis?

Approximately 95 percent of the patients diagnosed with plantar fasciitis respond favorably to nonsurgical treatment methods. The goals of treating plantar fasciitis are to relieve the pain and inflammation in the plantar ligament, allow tears and damage to heal, improve the flexibility and strength of the foot, correct feet problems that can stress the ligament and allow you to get back to normal activities. As soon as you develop heel pain, there are several things you can do to help ease the pain, including limiting daily activities that cause pain (running or standing on hard surfaces), resting your foot as much as possible, wearing shoes that have shock absorption and arch support, stretches to improve flexibility in the foot and reducing inflammation with the use of anti-inflammatory medications. You can also ice the heel to decrease inflammation and relieve pain.

  • The doctor may recommend custom-made orthotics. This is a custom-made insert that fits into your shoe to hold the foot to take pressure off the plantar fascia, reduce inflammation, and relieve pain. Night splints may also be recommended. A night splint keeps the foot and ankle at a 90-degree angle and the toes pointed upward. This produces a constant gentle stretch throughout the night. A walking cast may also be recommended. Walking casts keep the foot in one location so that it can rest and heal.

  • Physical therapy may be also be recommended as it helps to stretch the ligament through gentle exercises. In addition to exercise, a physical therapist may use massage therapy, cold and heat therapy, electrical stimulation and ultrasound to help relieve the pain, reduce inflammation, increase blood flow to the area, and help the foot structures heal quickly.

  • Cortisone injections are sometimes recommended. The doctor will inject the steroid cortisone directly into the plantar fascia. This procedure can be quite painful. The physician may also include numbing medications to help relieve the pain. The cortisone is used to encourage healing and reduce inflammation in the plantar ligament.

  • Chiropractic adjustments are used to help correct the contributing causes of fasciitis, such as excess pronation when walking. Oftentimes, plantar fasciitis results from poor posture. A chiropractor will make adjustments to the spine to help correct and improve your posture. Another common issue that causes plantar fasciitis is poor weight distribution. This can occur when the body is not aligned. When a misalignment of the spine occurs, your gait can be affected and you may place more weight on one foot, which increases the amount of weight and pressure placed on the fascia.

  • Cold laser therapy, or low-level laser treatment, can help to relieve pain and reduce inflammation of the plantar fascia. This form of treatment uses a low-level laser to encourage wound healing, increase the immune response and encourage protein synthesis and cellular metabolism. Numerous studies have shown that cold laser therapy can help relieve pain. This type of treatment does not cause degeneration of the plantar fascia and does not cause trauma to the foot the same way cortisone injections do. The cold laser offers a non-invasive form of treatment. It stimulates the healing process, reduces inflammation and relieves pain. This type of treatment does not require anesthesia or pain medication. With the right treatment, patients are able to continue their day to day activities without pain or limitation.

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