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Plantar Fasciitis

Plantar fasciitis is one of the most common causes of heel pain. It involves the painful inflammation of the plantar fascia, a ligament that runs across the bottom of your foot and connects your heel bone to your toes. This ligament acts as a shock absorber and supports the arch.

Plantar fasciitis occurs when this band of tissue is overloaded or overstretched. This causes small tears in the fascia’s fibers, especially where the fascia meets the heel bone. The result is pain and tenderness in the heel area, making it difficult to bear weight and walk.

You are more likely to get plantar fasciitis if you are obese, which reflects 70% of patients with this condition. Pregnant women are also susceptible, probably because their extra body weight overloads the delicate plantar fascia. Having high-arched feet or flat feet is a risk factor, as well as is standing for prolonged periods.

Plantar fasciitis also can be triggered by physical activities that overstretch the fascia, particularly for athletes following intense training – and especially for runners and jumpers. Worn or poorly constructed shoes can contribute to the problem if they do not provide enough arch support, heel cushion, or sole flexibility.

Treatment for Plantar Fasciitis

Most people who have plantar fasciitis recover in several months with conservative treatment, including resting, icing the painful area, and stretching. However, the longer the symptoms have been present and the more severe the pain, the longer the treatment may take. Additionally, high-intensity athletes, such as cross-country or marathon runners, may require a longer course of treatment.

Plantar fasciitis treatment options include:

Medications

Your doctor may also recommend nonsteroidal anti-inflammatory medications to ease the pain and inflammation.

Stretching and Physical Therapy

Stretching and strengthening exercises are some of the best treatments to relieve symptoms. A  physical therapist can show you a series of exercises to stretch the plantar fascia and Achilles tendon and strengthen lower leg muscles. They may also teach you to apply athletic taping to support the bottom of your foo

Rest, Activity Modification, and Orthotics

A self-help effort to keep the weight and stress off your foot, at least partially, while your plantar fascia is healing. Your doctor may recommend a combination of the following:

  • Changing to a more shock-absorbing exercise surface.
  • Switching to shoes with arch support.
  • Orthotics – off-the-shelf or custom-fitted arch supports (orthotics) to help distribute pressure to your feet more evenly.
  • Wearing night splints that stretches your calf and the arch of your foot while you sleep. This holds the plantar fascia and Achilles tendon in a lengthened position overnight to promote stretching.
  • Decreasing distances and duration of walking or running.
  • Switching from jumping or running to swimming or cycling.

Steroid Injections

In most cases, plantar fasciitis improves after a few months of stretching. If your symptoms continue after two months of treatment, your doctor may recommend steroid injections to decrease inflammation.

However, multiple injections aren’t advised because they can weaken your plantar fascia and possibly cause it to rupture.

Surgical or Advanced Procedures

If more-conservative measures aren’t working or aren’t viable, your doctor might recommend that you see a Doctor of Podiatric Medicine (DPM) to consider more advanced procedures or surgery.

Video Overview: Plantar Fasciitis

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