Plantar Fasciitis
The Planta Fascia is the flat band of tissue (ligament) that connects your heel bone to your toes. It supports the arch of your foot.
If you strain your plantar fascia, it gets weak, swollen, and irritated. This can then cause your heel or the bottom of your foot to hurt when you stand or walk.
It is estimated that 1 in 10 adults will develop planta fasciitis during their life time.
Plantar Fasciitis is caused by straining the ligament that supports the arch of your foot. Repeated strain can cause tiny tears and thus lead to degeneration in the ligament. These can lead to pain, most commonly on the inside of the heel and swelling.
This is more likely to happen if:
- Your feet pronate or roll in when you walk or you have high arches.
- You walk, stand, or run for long periods of time, especially on hard surfaces.
- You are overweight.
- You wear shoes that don't fit well or are worn out.
- You have a tight Achilles tendon or calf muscles.
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. The pain and stiffness may reduce after you have taken a few steps. However your foot may hurt more as the day goes on especially when you climb stairs or after you stand for a long time.
Treatment aims:
- Relieve inflammation and pain in the heel.
- Allow small tears in the plantar fascia ligament to heal.
- Improve strength and flexibility and correct foot postures such as excessive pronation so that you don't stress the plantar fascia ligament.
- Allow you to go back to your normal activities.
Physiotherapy assessment and treatment is paramount in providing the correct rehabilitation for this condition. The physiotherapist will fully assess the lower limb to ascertain the cause of symptoms. They will then guide you as to the correct exercises and treatment.
Treatment will more than likely include stretches and strengthening for the lower limb and foot. Anti-inflammatory medicines may be recommended and corticosteroid injections or extracorporeal shock wave therapy.
Current studies have also shown that local injection of autologous platelet rich plasma provides significant relief of pain and improvement of function and that the results are often superior to local steroid injection. The PRP injection can stimulate the repair process.
Surgical intervention is not normally preformed in the majority of sufferers but if it is indicated there are a couple of options:
Plantar Fascia Release where the planta fascia ligament is cut to release the tension within it.
Other procedures can include removing a heel spur or stretching specific foot nerves.
These surgeries are usually done in combination with the release when there is lasting heel pain.
Experts in the past thought that heel spurs caused plantar fasciitis. Now experts generally believe that heel spurs are the result, not the cause, of plantar fasciitis. Many people with large heel spurs never have heel pain or plantar fasciitis. So surgery to remove heel spurs is rarely done.
The following steps will help prevent plantar fasciitis or help keep the condition from getting worse if you already have it:
- Take care of your feet.
- Wear shoes with good arch support and heel cushioning.
- If your work requires you to stand on hard surfaces, stand on a thick rubber mat to help reduce stress on your feet.
- Continued exercises to stretch the Achilles tendon and calf muscles.
- Stay at a healthy weight for your height.
- If you run, alternate running with other sports that will not cause heel pain.
- Put on supportive shoes as soon as you get out of bed.
- Going barefoot or wearing slippers puts stress on your feet so avoid shoes that provide little or no support during the day; for example flip flops and ballet pumps.
Source:
WebMD
J Res Med Sci 2012 Aug; 17(8): 799–804.