The plantar fascia is a ligament that connects the heel to the toes on the bottom of the foot. It lies just below the skin layers as it passes over the arch of the foot. A common ailment called
plantar fasciitis is the result of this ligament becomes inflamed. This can Foot anatomyhappen from injury, physical stress, or sometimes for no obvious reason. The most common point for this
inflammation is where this ligament joints the heel bone. Typical symptoms are the pain on the bottom of the foot near the heel usually most intense in the mornings when arising or after a long
period with little movement. The pain typically diminishes with movement. Many suffering from plantar fasciitis have heel spurs. Even though they are in the same area they are unrelated and the heel
spurs do not cause the plantar fasciitis. Most times heel spurs will not cause pain and in many go undetected unless they have an x-ray for some other reason.
Plantar fasciitis generally occurs over time, rather than being the result of a single event. Micro trauma from repetitive stress to the tissue often combines with a biomechanical deficiency of the
foot to produce the condition. In addition, arthritic and metabolic factors may contribute to the development of this injury, (though they are unlikely to affect young athletes). A variety of
training errors commonly lead to plantar fasciitis, particularly a rapid increase in either volume or intensity of athletic activity. Volume refers to the distance or time an athlete performs, while
intensity refers to the pace of activity and/or the recovery time allowed following performance.
The pain is more intense with your first steps out of bed in the morning or after sitting for a while. The reason for this is that during rest our muscles and ligaments tend to shorten and tighten
up. The tightening of the plantar fascia means more traction on the ligament making the tissue even more sensitive. With sudden weight-bearing the tissue is being traumatised, resulting in a stabbing
pain. After walking around for a while the ligament warms up, becomes a little bit more flexible and adapts itself, making the pain go way entirely or becoming more of a dull ache. However, after
walking a long distance or standing for hours the pain will come back again. To prevent the sudden sharp pain in the morning or after sitting, it is important to give the feet a little warm-up first
with some simple exercises. Also, any barefoot walking should be avoided, especially first thing in the morning, as this will damage to the plantar fascia tissue. Aparty from pain in the heel or
symptoms may include a mild swelling under the heel. In addition, heel pain is often associated with tightness in the calf muscles. Tight calf muscles are a major contributing factor to Plantar
Your doctor will check your feet and watch you stand and walk. He or she will also ask questions about your past health, including what illnesses or injuries you have had. Your symptoms, such as
where the pain is and what time of day your foot hurts most. How active you are and what types of physical activity you do. Your doctor may take an X-ray of your foot if he or she suspects a problem
with the bones of your foot, such as a stress fracture.
Non Surgical Treatment
Talk to your doctor about the best treatment plan for you. Options include. Apply ice or a cold pack to the heel and arch for 15 to 20 minutes several times a day. Wrap the ice or cold pack in a
towel. Do not apply the ice directly to your skin. A special splint that will hold your foot in a neutral position while sleeping. Special shoe inserts that support the mid-arch region of your foot.
Inserts that are not customized may work just as well as those that are customized. Activity. Avoid running and other activities that may worsen pain. Begin stretching exercises to lengthen the
Achilles tendon and plantar fascia as recommended by your doctor. This is usually done when pain has lessened or improved. To help manage pain, your doctor may recommend over-the-counter nonsteroidal
anti-inflammatory medication (NSAIDs), such as ibuprofen or naproxen. Prescription pain relievers may also be required. Steroid injections may be used in some cases or if other treatment is not
working. A special type of sound wave called extracorporeal shock wave may also be considered in certain cases. This treatment happens under the care of your doctor. At this time, this is generally a
treatment for long-term cases that do not respond to other treatments. Massage therapy or accupuncture may also be effective for long-term cases. In a few cases, basic treatments don't help. Surgery
may be performed to cut the tight, swollen fascia.
Surgery may be considered in very difficult cases. Surgery is usually only advised if your pain has not eased after 12 months despite other treatments. The operation involves separating your plantar
fascia from where it connects to the bone; this is called a plantar fascia release. It may also involve removal of a spur on the calcaneum if one is present. Surgery is not always successful. It can
cause complications in some people so it should be considered as a last resort. Complications may include infection, increased pain, injury to nearby nerves, or rupture of the plantar fascia.