Plantar fasciitis is one of the most common sources of heel pain. Your plantar fascia is a thick fibrous band of connective tissue originating on the bottom surface of the calcaneus (heel bone) and
extending along the sole of the foot towards the toes. Your plantar fascia acts as a passive limitation to the over flattening of you arch. When your plantar fascia develops micro tears or becomes
inflammed it is known as plantar fasciitis.
This is a problem of either extreme, so people with high arches or those that have very flat feet are at risk of developing pain in this region. This is because of the relative stress the plantar
fascia is put under. In people with excessive pronation, the plantar fascia is put under too much stretch, as their range flattens and strains it. People with a stiff, supinated (high-arched) foot
lack the flexibility to appropriately shock absorb, so this too puts extra strain on the plantar fascia. Clinically, we see more people presenting with plantar fascia pain who have excessive
pronation than those with stiff, supinated feet. But while the foot type is the biggest risk factor for plantar fasciitis, the whole leg from the pelvis down can affect how the foot hits the ground.
A thorough biomechanical assessment will determine where in the kinetic chain things have gone wrong to cause the overload.
Patients experience intense sharp pain with the first few steps in the morning or following long periods of having no weight on the foot. The pain can also be aggravated by prolonged standing or
sitting. The pain is usually experienced on the plantar surface of the foot at the anterior aspect of the heel where the plantar fascia ligament inserts into the calcaneus. It may radiate proximally
in severe cases. Some patients may limp or prefer to walk on their toes. Alternative causes of heel pain include fat pad atrophy, plantar warts and foreign body.
To diagnose plantar fasciitis, your doctor will physically examine your foot by testing your reflexes, balance, coordination, muscle strength, and muscle tone. Your doctor may also advise a magnetic
resonance imaging (MRI) or X-ray to rule out other others sources of your pain, such as a pinched nerve, stress fracture, or bone spur.
Non Surgical Treatment
Although there is no single cure, many treatments can be used to ease pain. In order to treat it effectively for the long-term, the cause of the condition must be corrected as well as treating the
symptoms. Rest until it is not painful. It can be very difficult to rest the foot as most people will be on their feet during the day for work. A plantar fasciitis taping technique can help support
the foot relieving pain and helping it rest. Plantar fasciitis tapingApply ice or cold therapy to help reduce pain and inflammation. Cold therapy can be applied for 10 minutes every hour if the
injury is particularly painful for the first 24 to 48 hours. This can be reduced to 3 times a day as symptoms ease. Plantar fasciitis exercises can be done if pain allows, in particular stretching
the fascia is an important part of treatment and prevention. Simply reducing pain and inflammation alone is unlikely to result in long term recovery. The fascia tightens up making the origin at the
heel more susceptible to stress. Plantar fasciitis night splint. Plantar fasciitis night splint is an excellent product which is worn overnight and gently stretches the calf muscles preventing it
from tightening up overnight.
Surgery is not a common treatment for this condition. Approximately 5% of people with plantar fasciitis require surgery if non-surgical methods do not help to relieve pain within a year. The surgical
procedure involves making an incision in the plantar fascia in order to decrease the tension of the ligament. Potential risks of this surgical procedure include irritation of the nerves around the
heel, continued plantar fasciitis, heel or foot pain, infection, flattening of the arch, problems relating to the anesthetic.
You may begin exercising the muscles of your foot right away by gently stretching them as follows. Prone hip extension, Lie on your stomach with your legs straight out behind you. Tighten up your
buttocks muscles and lift one leg off the floor about 8 inches. Keep your knee straight. Hold for 5 seconds. Then lower your leg and relax. Do 3 sets of 10. Towel stretch, Sit on a hard surface with
one leg stretched out in front of you. Loop a towel around your toes and the ball of your foot and pull the towel toward your body keeping your knee straight. Hold this position for 15 to 30 seconds
then relax. Repeat 3 times. When the towel stretch becomes too easy, you may begin doing the standing calf stretch. Standing calf stretch, Facing a wall, put your hands against the wall at about eye
level. Keep one leg back with the heel on the floor, and the other leg forward. Turn your back foot slightly inward (as if you were pigeon-toed) as you slowly lean into the wall until you feel a
stretch in the back of your calf. Hold for 15 to 30 seconds. Repeat 3 times. Do this exercise several times each day. Sitting plantar fascia stretch, Sit in a chair and cross one foot over your other
knee. Grab the base of your toes and pull them back toward your leg until you feel a comfortable stretch. Hold 15 seconds and repeat 3 times. When you can stand comfortably on your injured foot, you
can begin standing to stretch the bottom of your foot using the plantar fascia stretch. Achilles stretch, Stand with the ball of one foot on a stair. Reach for the bottom step with your heel until
you feel a stretch in the arch of your foot. Hold this position for 15 to 30 seconds and then relax. Repeat 3 times. After you have stretched the bottom muscles of your foot, you can begin
strengthening the top muscles of your foot. Frozen can roll, Roll your bare injured foot back and forth from your heel to your mid-arch over a frozen juice can. Repeat for 3 to 5 minutes. This
exercise is particularly helpful if done first thing in the morning. Towel pickup, With your heel on the ground, pick up a towel with your toes. Release. Repeat 10 to 20 times. When this gets easy,
add more resistance by placing a book or small weight on the towel. Balance and reach exercises, Stand upright next to a chair. This will provide you with balance if needed. Stand on the foot
farthest from the chair. Try to raise the arch of your foot while keeping your toes on the floor. Keep your foot in this position and reach forward in front of you with your hand farthest away from
the chair, allowing your knee to bend. Repeat this 10 times while maintaining the arch height. This exercise can be made more difficult by reaching farther in front of you. Do 2 sets. Stand in the
same position as above. While maintaining your arch height, reach the hand farthest away from the chair across your body toward the chair. The farther you reach, the more challenging the exercise. Do
2 sets of 10. Heel raise, Balance yourself while standing behind a chair or counter. Using the chair to help you, raise your body up onto your toes and hold for 5 seconds. Then slowly lower yourself
down without holding onto the chair. Hold onto the chair or counter if you need to. When this exercise becomes less painful, try lowering on one leg only. Repeat 10 times. Do 3 sets of 10. Side-lying
leg lift, Lying on your side, tighten the front thigh muscles on your top leg and lift that leg 8 to 10 inches away from the other leg. Keep the leg straight. Do 3 sets of 10.