The job of the plantar fascia is to aid the footâs bone structure to absorb shock that happens during your gait (walking pattern). Even though it goes against common perception you can have a
high-arch foot and get plantar fasciitis as well as the more common low-arch foot posture associated with PF - tightness doesnât discriminate! The plantar fascia is involved in stabilizing your
foot not only at heel strike, when most people experience pain, but also right through until the foot leaves the ground after the stress has moved from the back of the foot to the big and lesser toes
as you âpush offâ - all this increases the stress on the plantar fascia and not just at the point where it is attached to the heel bone. What most people, even medical professionals, donât
realise is that is has been happening for a long time before it becomes evident (you only notice it when your heel starts to hurt when you stand and move).
Identified risk factors for plantar fasciitis include excessive running, standing on hard surfaces for prolonged periods of time, high arches of the feet, the presence of a leg length inequality, and
flat feet. The tendency of flat feet to excessively roll inward during walking or running makes them more susceptible to plantar fasciitis. Obesity is seen in 70% of individuals who present with
plantar fasciitis and is an independent risk factor. Studies have suggested a strong association exists between an increased body mass index and the development of plantar fasciitis. Achilles tendon
tightness and inappropriate footwear have also been identified as significant risk factors.
Plantar fasciitis is the inflammation of the plantar fascia - a band of tough fibrous tissue running along the sole of the foot. It occurs when small tears develop in the plantar fascia, leading to
inflammation and heel pain. The plantar fascia tissue branches out from the heel like a fan, connecting the heel bone to the base of the toes. When the foot moves, the plantar fascia stretches and
contracts. The plantar fascia helps to maintain the arch of the foot in much the same way that the string of a bow maintains the bow's arch. The most notable symptom of plantar fasciitis is heel
pain. This is typically most severe in the middle of the heel though it may radiate along the sole of the foot. The pain is most often felt when walking first thing in the morning or after a period
of rest. As walking continues the pain may decrease; however some degree of pain remains present on movement. The pain may disappear when resting, as the plantar fascia is relaxed. Redness, swelling
and warmth over the affected area may also be noticed. The onset of plantar fasciitis is gradual and only mild pain may be experienced initially. However, as the condition progresses the pain
experienced tends to become more severe. Chronic plantar fasciitis may cause a person to change their walking or running action, leading to symptoms of discomfort in the knee, hip and back.
Your doctor will check your feet and watch you stand and walk. He or she will also ask questions about your past health, including what illnesses or injuries you have had. Your symptoms, such as
where the pain is and what time of day your foot hurts most. How active you are and what types of physical activity you do. Your doctor may take an X-ray of your foot if he or she suspects a problem
with the bones of your foot, such as a stress fracture.
Non Surgical Treatment
Treatment of plantar fasciitis is sometimes a drawn out and frustrating process. A program of rehabilitation should be undertaken with the help of someone qualified and knowledgeable about the
affliction. Typically, plantar fasciitis will require at least six weeks and up to six months of conservative care to be fully remedied. Should such efforts not provide relief to the athlete, more
aggressive measures including surgery may be considered. The initial goals of physical therapy should be to increase the passive flexion of the foot and improve flexibility in the foot and ankle,
eventually leading to a full return to normal function. Prolonged inactivity in vigorous sports is often the price to be paid for thorough recovery. Half measures can lead to a chronic condition, in
some cases severely limiting athletic ability. As a large amount of time is spent in bed during sleeping hours, it is important to ensure that the sheets at the foot of the bed do not constrict the
foot, leading to plantar flexion in which the foot is bent straight out with the toes pointing. This constricts and thereby shortens the gastroc complex, worsening the condition. A heating pad placed
under the muscles of the calf for a few minutes prior to rising may help loosen tension, increase circulation in the lower leg and reduce pain. Also during sleep, a night splint may be used in order
to hold the ankle joint in a neutral position. This will aid in the healing of the plantar fascia and ensure that the foot will not become flexed during the night.
When more-conservative measures aren't working, your doctor might recommend steroid shots. Injecting a type of steroid medication into the tender area can provide temporary pain relief. Multiple
injections aren't recommended because they can weaken your plantar fascia and possibly cause it to rupture, as well as shrink the fat pad covering your heel bone. Extracorporeal shock wave therapy.
In this procedure, sound waves are directed at the area of heel pain to stimulate healing. It's usually used for chronic plantar fasciitis that hasn't responded to more-conservative treatments. This
procedure may cause bruises, swelling, pain, numbness or tingling and has not been shown to be consistently effective. Surgery. Few people need surgery to detach the plantar fascia from the heel
bone. It's generally an option only when the pain is severe and all else fails. Side effects include a weakening of the arch in your foot.
Calf stretch. Lean forward against a wall with one knee straight and the heel on the ground. Place the other leg in front, with the knee bent. To stretch the calf muscles and the heel cord, push your
hips toward the wall in a controlled fashion. Hold the position for 10 seconds and relax. Repeat this exercise 20 times for each foot. A strong pull in the calf should be felt during the stretch.
Plantar fascia stretch. This stretch is performed in the seated position. Cross your affected foot over the knee of your other leg. Grasp the toes of your painful foot and slowly pull them toward you
in a controlled fashion. If it is difficult to reach your foot, wrap a towel around your big toe to help pull your toes toward you. Place your other hand along the plantar fascia. The fascia should
feel like a tight band along the bottom of your foot when stretched. Hold the stretch for 10 seconds. Repeat it 20 times for each foot. This exercise is best done in the morning before standing or