Plantar Fasciitis

What Is a Plantar Fasciitis?

Plantar Fasciitis means inflammation of the plantar fascia, a think band of connective tissue that spans the arch of the foot from the calcaneus (heel bone) to the base of the toe. The function of this tissue is support of the longitudinal arch, and stabilizes the foot as the heel comes off the ground during push off. Plantar Fasciitis is the most common cause of heel pain.

Signs and Symptoms of Plantar Fasciitis

One or more of these symptoms may be present:

  • Heel pain in the morning when first rising from bed.
  • Pain when standing or sitting for prolonged periods of time.
  • Pain worsens when walking barefoot or upstairs.
  • Pain after intense activity

Causes of Plantar Fasciitis

  • Weight (i.e. High BMI)
  • Occupation that requires prolonged standing
  • Inappropriate footwear
  • Toe Running or Hill Running
  • Change or Increase in activity
  • Lack of flexibility in the calf muscles
  • Sudden Injury
  • Footwear – Not enough arch support / lack of cushioning

Conservative Treatment of Plantar Fasciitis

  • Stretching – This is the single most important aspect of treatment. Stretching should be performed at least 3 times per day as it aids in lengthening the plantar fascia and Achilles Tendon.
  • Ice – Icing is the preferred method to decrease inflammation. You can apply ice to the inflamed area for up to 20 minutes, three to four times a day to help relieve symptoms.
  • Anti-Inflammatory Techniques – Non-steroidal anti-inflammatories (NSAIDs) can be used intermittently to help decrease inflammation and pain.
  • Activity Modification – Any activities that worsen symptoms should be limited, and then once pain ceases gradual introduction to exercise should be take place.
  • Changes to Footwear – It is important to have appropriate fitting footwear that supports the foot and its arches.
  • Orthotic Therapy – Orthotics are used in footwear to help support the bones plantar facsia, which can relieve symptoms.
  • Injection Therapy – There are two methods of injection therapy:
    1. Corticosteroid injections under ultrasound are used to suppress the inflammation.
    2. Prolotherapy works to repair the weak and painful area.
  • Shockwave – Shockwave helps with reduction of pain by stimulating new blood flow in the area promoting tissue healing and regeneration.

Surgical Treatment of Plantar Fasciitis

For patients who have not received relief from other treatments after a 12-month period, there are surgical options.

It is important to speak to the podiatrist about this option and ask for a referral to a surgeon.

Following surgery conservative treatments such as orthotics are often advised.