Plantar fasciitis is one of the most common explanations of heel pain. It is caused by inflammation to the thick band that connects the toes to the heel bone, called the plantar fascia, which runs
across the bottom of your foot. The condition is most commonly seen in runners, pregnant women, overweight people, and individuals who wear inadequately supporting shoes. Plantar fasciitis typically
affects people between the ages of 40 and 70.
The plantar fascia can also become aggravated by repetitive activity. If you increase the number of times the heel hits the ground, that can cause plantar fasciitis, a number of people develop
problems when their feet are unaccustomed to hard tile or wood floors. Other risk factors for plantar fasciitis include obesity, an extra high or low foot arch, and activities like running.
The symptoms of plantar fasciitis include pain in the bottom of your foot, especially at the front or centre of the heel bone, pain that is worse when first rising in the morning (called "first-step
pain"), when first standing up after any long period of sitting, or after increased levels of activity especially in non-supportive shoes. Seek medical advice about plantar fasciitis if you have heel
pain or pain in the bottom of your foot, especially when you get up in the morning, that does not respond to treatment or if there is redness or bruising in the heel.
To arrive at a diagnosis, the foot and ankle surgeon will obtain your medical history and examine your foot. Throughout this process the surgeon rules out all the possible causes for your heel pain
other than plantar fasciitis. In addition, diagnostic imaging studies such as x-rays or other imaging modalities may be used to distinguish the different types of heel pain. Sometimes heel spurs are
found in patients with plantar fasciitis, but these are rarely a source of pain. When they are present, the condition may be diagnosed as plantar fasciitis/heel spur syndrome.
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.
In unusual cases, surgical intervention is necessary for relief of pain. These should only be employed after non-surgical efforts have been used without relief. Generally, such surgical procedures
may be completed on an outpatient basis in less than one hour, using local anesthesia or minimal sedation administrated by a trained anesthesiologist. In such cases, the surgeon may remove or release
the injured and inflamed fascia, after a small incision is made in the heel. A surgical procedure may also be undertaken to remove bone spurs, sometimes as part of the same surgery addressing the
damaged tissue. A cast may be used to immobilize the foot following surgery and crutches provided in order to allow greater mobility while keeping weight off the recovering foot during healing. After
removal of the cast, several weeks of physical therapy can be used to speed recovery, reduce swelling and restore flexibility.
Every time your foot strikes the ground, the plantar fascia is stretched. You can reduce the strain and stress on the plantar fascia by following these simple instructions: Avoid running on hard or
uneven ground, lose any excess weight, and wear shoes and orthotics that support your arch to prevent over-stretching of the plantar fascia.