Plantar-fasciitis-website-updated

The plantar fascia is a tough, flat band of tissue located right underneath the skin on the bottom of your foot. It connects the heel bone to your toes and supports the arch of your foot. Plantar fasciitis (fash-ee-EYE-tus) refers to inflammation and pain of the plantar fascia.

Symptoms

Pain on the bottom of the foot near the heel

Typically starts gradually with mild pain at the heel bone

Pain may be described as “stabbing”

Pain occurs after a period of rest, such as when first getting out of bed in the morning or after a period of sitting

Greater pain after, rather than during, exercise or activity

Causes

Anything that causes repetitive stretching or straining of the plantar fascia

Excessive foot pronation (rolling inward)

Faulty foot mechanics due to high arch or flat foot

Non supportive shoes

Obesity

New or increased activity

Repetitive impact activity, such as running

Tight calf muscles

Long periods of standing or walking on hard surfaces

Treatment

Treatment focus is on relieving pain and inflammation, stabilizing foot pronation and promoting healing. Conservative treatments are effective for most people within several months.

Over the counter pain medication, such as ibuprofen (Advil, Motrin) or naproxen (Aleve), as needed

Rest

Ice to affected area

Avoid walking barefoot or with slippers or sandals

Physical therapy / Calf and plantar fascia stretching program

Supportive shoes and orthotics

Night splints

Cortisone injection

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Plantar fasciitis is the most common cause of adult heel pain. It accounts for 10% of all foot and ankle healthcare visits to lower extremity healthcare specialists
The plantar fascia is a broad based ligament that originates from the bottom of the heel bone and fans out attaching to the base of the toes. Excessive mechanical stresses on the ligament can cause injury to the ligament at the level of attachment to the heel bone.
The “itis” in plantar fascitis denotes inflammation of this ligament as it attaches to the heel bone. Pain associated with this inflammation is noted typically to the bottom aspect the heel bone. Pain is typically worse with initial rising from a sitting position such as getting out of bed in the morning or pain noted after arising from a prolonged sitting period. X-rays are rarely indicated in the diagnosis of this condition.
The cause of plantar fasciitis has much more to do with inherited foot mechanics and abnormal stress placed on the plantar fascia. Abnormal foot pronation which can cause increase stress to the plantar fascia appears to be one of the main reasons for developing this injury. Other contributing factors including non supportive shoe gear, poor conditioning while returning too quickly to athletic activity and excessive body weight have an influence in its development.
The combination of decreasing the stress on the plantar fascia with a supportive shoe and orthotic as well as the use of anti-inflammatory medications including the potential use for cortisone injections are critical mainstays of treatment. Absolutely no barefoot, slippers or sandals should be used during this period of time. Secondary treatments including custom foot orthotics, physical therapy, walking casts and in rare incidence surgical care may be required to achieve full relief of pain. Short term low impact activity for exercise including bike, elliptical trainer and swimming will augment the recovery effort.
Throwing the “kitchen sink” at this condition with a comprehensive care plan generally allows a quicker return to pain free activity.

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