The Plantar Fascia is a broad, thick band of tissue that runs from under the heel to the front of the foot. Through overuse the fascia can become inflamed and painful at its attachment to the heel
bone or calcaneus. The condition is traditionally thought to be inflammation, however this is now believed to be incorrect due to the absence of inflammatory cells within the fascia. The cause of
pain is thought to be degeneration of the collagen fibres close to the attachment to the heel bone.
Plantar Fasciitis often leads to heel pain, heel spurs, and/or arch pain. The excessive stretching of the plantar fascia that leads to the inflammation and discomfort can be caused by the following:
Over-pronation (flat feet) which results in the arch collapsing upon weight bearing A foot with an unusually high arch A sudden increase in physical activity Excessive weight on the foot, usually
attributed to obesity or pregnancy Improperly fitting footwear Over-pronation (flat feet) is the leading cause of plantar fasciitis. Over-pronation occurs in the walking process, when a person's arch
collapses upon weight bearing, causing the plantar fascia to be stretched away from the heel bone. With Plantar Fasciitis, the bottom of your foot usually hurts near the inside of the foot where the
heel and arch meet. The pain is often acute either first thing in the morning or after a long rest, because while resting the plantar fascia contracts back to its original shape. As the day
progresses and the plantar fascia continues to be stretched, the pain often subsides.
If you are concerned that you may have developed this syndrome, review this list of symptoms to see if they match with your experience. Aching, sharp or burning pain in the sole of your foot, often
centering in the heel area. Foot pain that occurs as soon as you step out of bed or get to your feet after prolonged periods of sitting. Pain that may decrease eventually after you've been on your
feet for awhile, only to return later in the day. Sudden heel pain or pain that builds gradually. Foot pain that has lasted for more than a few days, or which you experience periodically over the
course of months or years. Pain in just one foot, though it is possible to have Plantar Fasciitis affect both feet. Swelling, redness, or feelings of heat in the heel area. Limping.
Most cases of plantar fasciitis are diagnosed by a health care provider who listens carefully to your description of symptoms. During an examination of your feet, your health care provider will have
to press on the bottom of your feet, the area most likely to be painful in plantar fasciitis. Because the pain of plantar fasciitis has unique characteristics, pain upon rising, improvement after
walking for several minutes, pain produced by pressure applied in a specific location on your foot but not with pressure in other areas, your health care provider will probably feel comfortable
making the diagnosis based on your symptoms and a physical examination. Your health care provider may suggest that you have an X-ray of your foot to verify that there is no stress fracture causing
Non Surgical Treatment
A change to properly fitting, appropriate shoes may be useful in some patients. Some individuals wear shoes that are too small, which can exacerbate many types of foot pain. Patients often find that
wearing shoes with thicker, well-cushioned midsoles, usually made of a material like high-density ethylene vinyl acetate (such as is found in many running shoes), decreases the pain associated with
long periods of walking or standing. Studies have shown that with age, running shoes lose a significant portion of their shock absorption. Thus, simply getting a new pair of shoes may be helpful in
decreasing pain. For individuals with flat feet, motion control shoes or shoes with better longitudinal arch support may decrease the pain associated with long periods of walking or standing. Motion
control shoes usually have the following characteristics: a straight last, board or combination lasted construction, an external heel counter, a wider flare and extra medial support. A change in
shoes was cited by 14 percent of patients with plantar fasciitis as the treatment that worked best for them.
Surgery is not a common treatment for this condition. Approximately 5% of people with plantar fasciitis require surgery if non-surgical methods do not help to relieve pain within a year. The surgical
procedure involves making an incision in the plantar fascia in order to decrease the tension of the ligament. Potential risks of this surgical procedure include irritation of the nerves around the
heel, continued plantar fasciitis, heel or foot pain, infection, flattening of the arch, problems relating to the anesthetic.
Do not walk barefoot on hard ground, particularly while on holiday. Many cases of heel pain occur when a person protects their feet for 50 weeks of the year and then suddenly walks barefoot while on
holiday. Their feet are not accustomed to the extra pressure, which causes heel pain. If you do a physical activity, such as running or another form of exercise that places additional strain on your
feet, you should replace your sports shoes regularly. Most experts recommend that sports shoes should be replaced after you have done about 500 miles in them.