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Nov 16, 2007 - Plantar FasciitisBack
PLANTAR FASCIITIS
Definition:
Plantar fasciitis is an inflammation caused by excessive stretching of the plantar fascia. The plantar fascia is a broad band of fibrous tissue that runs along the bottom surface of the foot, attaching at the bottom of the heel bone and extending to the forefoot. When the plantar fascia is excessively stretched, plantar fasciitis may result, causing heel pain, arch pain, and heel spurs.
Cause:
Plantar fasciitis is often associated with:
1. Over-pronation (flat feet), which results in the arch collapsing upon weight bearing.
2. A foot with an unusually high arch.
3. A sudden increase in physical activity – such as starting sporting activities, taking a long walk or going on an active holiday un-prepared and often with inappropriate footwear.
4. Excessive weight on the foot usually attributed to obesity or pregnancy.
5. Ill fitting or unsupportive footwear. Over-pronation is the leading cause of plantar fasciitis and may result in a person's arch collapsing upon weight bearing. This leads to the stretching of the plantar fascia away from its origin (the heel bone).
With plantar fasciitis, the bottom of your foot usually hurts on the inner side where the heel and arch meet. The pain is often acute either first thing in the morning or after a long rest. Pain is a result of both localized inflammation and tightening of the plantar fascia during the resting period. With activity or as the day progresses, the plantar fascia warms-up stretches out, and the pain often subsides.
Treatment & Prevention:
Conservative (non surgical) treatment will help virtually all of the patients with this condition. It is by far the most common foot condition to present in our clinics and one with which we have much experience.
The key for the proper treatment of plantar fasciitis is determining what is causing the excessive stretching or trauma of the plantar fascia. When the cause is over-pronation, a motion controlling orthotic is an effective device to allow the condition to improve. If the cause is un-usually high arches, again an orthotic will be effective – however in this case it will be designed to cushion the heel and absorb shock.
In some cases we will advocate the use of plantar fasciitis night splints. This is particularly useful in patients who have acute and debilitating morning pain or those who are failing to respond to orthoses. Use of proper footwear to accommodate and comfort the foot is also an essential part of treatment. We often recommend our clients wear running shoes and supportive sandals during the early stages of treatment to provide good support and cushioning. Physiotherapy, shockwave therapy and/or cortisone injections are also treatment considerations. Rarely does this condition require surgical intervention.
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