Plantar Fasciitis is considered a chronic injury rather than an acute injury. It is common in runners performing repetitive plantar flexion and dorsiflexion of the foot. It is also common with sudden weight gain.
The plantar fascia provides support for the medial longitudinal arch of the foot. The plantar fascia is stretched and the arch flattens slightly to absorb the impact each time the heel impacts the ground. The fascia is not very flexible and such repetitive stretching from impact can result in small tears in the fascia.
Plantar Faciitis Symptoms
Heel pain during the first steps of the morning is a classic sign of plantar fasciitis. This pain is the result of the foot resting in plantar flexion overnight. This allows the fascia to shorten. When the shortened fascia is stretched pain occurs. Pain is also common at the start of exercise and when resuming activity after rest. A history of recent weight gain or a sudden change in exercise pattern also is a sign of plantar fasciitis.Pain continues due to the chronic inflammation of the torn fascia. A heel spur can be a sign of fasciitis, but is typically not a cause. About half of patients with plantar fasciitis have spurs.
Plantar Faciitis Causes
Typical causes of Plantar Fasciitis include overstretching a tight plantar fascial band or general overuse causing microtears to the fascia at its calcaneal (heel bone) origin.Predisposing factors include:
- Flat feet
- High arches
- Excessive pronation
- Obesity or sudden weight gain.
- Tight Achilles tendons. (See: Achilles tendon stretch.
- Sudden increase in activity intensity, time or type. (See: The Ten Percent Rule for Increasing Activity)
- Wearing shoes with poor cushioning. (See: Before You Buy Running Shoes)
- Change in running or walking surface.
- Prolonged standing or weight bearing.
Plantar Faciitis Treatment
Nonsteroidal anti-inflammatory drugs can be used for 2-4 weeks in conjunction with other treatments. (Check with your doctor for specific instructions).It is important for those with plantar faciitis to avoid irritating activities, and barefoot walking on hard surfaces. Other treatments include weight loss when appropriate, or taping the heel and arch to also help reduce pain. Medial longitudinal arch supports, can be used if they produce a positive result.
Massaging the fascia by rolling foot over a 3-4 inch diameter tube such as a rolling pin or soup can has be an effective treatment.
Plantar Faciitis Stretching
A new stretching technique has proven effective at reducing the pain of plantar faciitis when performed several times a day. It is performed by crossing one leg over the other and pulling the toes toward the shin for a count of ten and repeating ten times. This is a change from the standard treatment that recommends the weight-bearing stretches.
Strengthening exercises include scrunching up a hand towel with the toes or pulling a towel weighted with a soup can across the floor. After exercising, applying a cold pack to heel at point of maximal tenderness for 15-20 minutes can relieve pain.
Proper footwear with arch support is also recommended.
Any foot injury that does not respond to treatment in 1-2 weeks may be more serious. Always consult a physician for a thorough evaluation and diagnosis.
Source
B.F. DiGiovanni, MD, et al. Tissue-Specific Plantar Fascia-Stretching Exercise Enhances Outcomes in Patients with Chronic Heel Pain, The Journal of Bone and Joint Surgery, 2003: 85:1270-1277.
Plantar fasciitis, Patient Information. A.D.A.M., Inc.
