Heel Pain (Plantar Fasciitis)
Plantar fasciitis is the most commonly occurring heel pain seen in runners, obese people and pregnant women. The thick band of tissues in the bottom of your feet get inflamed, causing pain. The heel pain is usually felt on the inside of the heel. The pain is also felt along the arch of the feet and along the border of the heel. You feel a stabbing pain, especially, in the morning as the plantar fascia tightens up. The pain reduces as the tissues stretch, but it may worsen if you stand, walk or run. This condition is seen in athletes, dancers and jumpers.
Plantar fasciitis Classification and external resources. Plantar fasciitis PF is a painful inflammatory process of the plantar fascia, the connective tissue on the sole bottom surface of the foot. It is often caused by overuse of the plantar fascia or arch tendon of the foot. The plantar fascia is a thick fibrous band of connective tissue originating on the bottom surface of the calcareous heel bone and extending along the sole of the foot towards the toes. A symptom commonly recognized among sufferers of plantar fasciitis is an increased probability of knee pains, especially among runners.
Is there a difference between Plantar Fasciitis and heel spurs? While there is a difference between the two conditions, they are related. Plantar fasciitis is a condition where the thick tissue on the bottom or your foot becomes irritated and swollen. Plantar Fasciitis means inflammation of your plantar fascia. The plantar fascia is tissue that holds up the bones on the bottom of your foot. When you have this condition you usually feel pain in the bottom or your heel. This may be due to arch problems. When your plantar fascia pulls away from the heel, calcium deposits can form there.
Most people experience pain on the heel when they wake up in the morning and begin to walk. There is less pain and stiffness after a while; however, the pain may increase during the day. The pain can occur when you stand or sit for a long time too. The illness is caused when there is strain on the ligament that provides support to the arch. Tiny ligament tears are caused when there are repeated strains resulting in swelling and pain. Continued stretching of the plantar fascia can result in heel spur which is a bone-like development on the heel. Flat feet or high arches can be a cause.
An easy home exercise for plantar fasciitis involves the use of a tennis ball or any small ball that is comfortable to use on the bottom of the foot. The exercise is performed by placing the bottom of the foot on top of the ball and gently rolling the ball back and forth. This is thought to massage the muscles and stretch the muscles along the sole of the foot to relieve tension. This can be performed while seated or standing while holding on the a wall or chair. The exercise can be performed for 30 seconds to a minute at a time followed by a period of rest.
Originally is was assumed that Plantar Fasciitis was just an inflammatory condition, however inflammation is only rarely the cause. Individuals with flat feet/no arches or very high arches are more prone to plantar fasciitis than individuals with normal arches. Other causes or risk factors for plantar fasciitis are sudden weight gain or obesity, long distance running, and poor arch support in shoes. I have extremely flat and pronated feet, had gained weight rapidly during each of my pregnancies and also didn’t get orthotic inserts regularly, choosing rather to try and extend the life of old supports.
Plantar fasciitis pain can last six to 18 months or longer, so it is important to be patient. Your podiatrist will evaluate your feet to determine if you need to have special supports, called orthotics, inserted into your regular shoes or your running shoes. You may be asked to stop carrying heavy weights or participating in sports until your foot heals. Your podiatrist may refer you to a physical therapist to start a series of exercises to strengthen and stretch your foot and calf muscles, including wall stretches and stair stretches. Medical Interventions.
Stand barefoot, with your feet hip-width apart and with your left foot in a slightly forward position - two to three inches ahead of your right foot. The bottoms of the toes of your left foot should be in contact with a wall in front of you (the wall should be creating a forced dorsiflexion of the toes, so that the sole of the left foot is on the ground but the toes are on the wall), and your left knee should be bent slightly. Keep your weight evenly distributed between your right and left foot to start the exercise (see note below).
Shoe modifications are also important. Wearing the proper shoe and in some cases in combination with a custom orthotics helps to cushion and support the foot and keep the plantar fascia supported to stop excessive strain on the foot. Custom orthotic devices are custom molded to your foot and prevent any biomechanical defects with your foot to help aid in recovery and prevent future recurrences. Night splints are also used at night to keep the plantar fascia stretched to reduce morning pain associated with this condition. Injection therapy can be combined with the above modalities.
How quickly you can return to running will depend on the severity of your injury and how fast you heal. Some runners find that they can work their way back into running even while some residual arch stiffness persists, but if running is making your arch pain worse, you need more time off and more time for your rehab program to do its job. As you return to running, consider increasing your stride frequency by 10% or so to reduce your impact loading rate,16 a factor connected with the development of plantar fasciitis in runners.
