Plantar fasciitis, or better termed chronic plantar heel pain, is likely caused by a combination of heel Compression, from standing with weight distributed on the heels. Abnormal stress on the foot,
from decreased ankle flexibility, pronation, or a high BMI. Footwear, particularly a rigid sole and toe spring, which interferes with foot muscle activity, restricts circulation, and hinders the
plantar fasciaâs ability to absorb forces. Contrary to popular belief, the condition is not caused by inflammation in the traditional sense, and supportive footwear is possibly more likely to
contribute to the problem than help it. Plantar fasciitis doesnât develop from overuse or too much stress on plantar fascia. It happens when the wrong kind of stress replaces the good kind of
stress that the foot needs to remain healthy. The aim of treatment therefore should not be reducing stress on the arch. Instead, treatment should focus on changing the types of stresses being applied
and encouraging normal function of the foot.
Plantar fasciitis is usually not the result of a single event but more commonly the result of a history of repetitive micro trauma combined with a biomechanical deficiency of the foot. Arthritic
changes and metabolic factors may also playa part in this injury but are unlikely in a young athletic population. The final cause of plantar fasciitis is "training errors." In all likelihood the
injury is the result of a combination of biomechanical deficiencies and training errors. Training errors are responsible for up to 60% of all athletic injuries (Ambrosius 1992). The most frequent
training error seen with plantar fasciitis is a rapid increase in volume (miles or time run) or intensity (pace and/or decreased recovery). Training on improper surfaces, a highly crowned road,
excessive track work in spiked shoes, plyometrics on hard runways or steep hill running, can compromise the plantar fascia past elastic limits. A final training error seen in athletics is with a
rapid return to some preconceived fitness level. Remembering what one did "last season" while forgetting the necessity of preparatory work is part of the recipe for injury. Metabolic and arthritic
changes are a less likely cause of plantar fasciitis among athletes. Bilateral foot pain may indicate a metabolic or systemic problem. The definitive diagnosis in this case is done by a professional
with blood tests and possibly x-rays.
Plantar fascia usually causes pain and stiffness on the bottom of your heel although some people have heel spurs and suffer no symptoms at all. Occasionally, heel pain is also associated with other
medical disorders such as arthritis (inflammation of the joint), bursitis (inflammation of the tissues around the joint). Those who have symptoms may experience âFirst stepâ pain (stone bruise
sensation) after getting out of bed or sitting for a period of time. Pain after driving. Pain on the bottom of your heel. Deep aching pain. Pain can be worse when barefoot.
Your doctor will ask you about the kind of pain you're having, when it occurs and how long you've had it. If you have pain in your heel when you stand up for the first time in the morning, you may
have plantar fasciitis. Most people with plantar fasciitis say the pain is like a knife or a pin sticking into the bottom of the foot. After you've been standing for a while, the pain becomes more
like a dull ache. If you sit down for any length of time, the sharp pain will come back when you stand up again.
Non Surgical Treatment
Your health care provider will often recommend these steps first Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) to reduce pain and inflammation. Heel and foot stretching exercises. Night
splints to wear while sleeping to stretch the foot. Resting as much as possible for at least a week. Wearing shoes with good support and cushions. Other steps to relieve pain include aply ice to the
painful area. Do this at least twice a day for 10 - 15 minutes, more often in the first couple of days. Try wearing a heel cup, felt pads in the heel area, or shoe inserts. Use night splints to
stretch the injured fascia and allow it to heal. If these treatments do not work, your health care provider may recommend waring a boot cast, which looks like a ski boot, for 3 - 6 weeks. It can be
removed for bathing. Custom-made shoe inserts (orthotics). Steroid shots or injections into the heel. Smetimes, foot surgery is needed.
When more conservative methods have failed to reduce plantar fasciitis pain, your doctor may suggest extracorporeal shock wave therapy, which is used to treat chronic plantar fasciitis.
Extracorporeal shock wave therapy uses sound waves to stimulate healing, but may cause bruises, numbness, tingling, swelling, and pain. When all else fails, surgery may be recommended to detach the
plantar fascia from the heel bone. Few people need surgery to treat the condition.