Plantar facsitisinfo

Plantar Fascitis

A Common Foot Problem

Plantar Fascia

This fascia is the connective tissue that supports the connective tissue of the foot. It is very strong but overuse and injury will lead to painful plantar fascitis.

Plantar Fascitis

Is pain usually in the front of the heel (see diagram). Typically pain is worse in the morning and with activity. This condition is due to pain in the plantar fascia (or thick connective tissue of the foot) which may be injured from trauma or repetitive use.

It is sometimes wrongly referred to as “heel spurs” but actually is the painful inflammation of the fascia that causes the pain. Many people have heel spurs but no pain so doing x-rays to check for the presence of the heel spurs is not recommended. Instead the goal of treatment is to treat the painful inflammation of the plantar fascia.

Treatment includes:

• Rest from aggravating activity

• Ice

• Anti-inflammatory medication

• Therapy (Athletic therapy and Physiotherapy are both specialties that assess and guide sports injuries through a program that is appropriate for each individual and injury. They may use modalities such as therapeutic ultrasound and heart (among others) with an exercise program to restore pain free function.

• Orthotics are useful to correct predisposing foot problems if they exist. Proper orthotics can be designed by a Podiatrist, Athletic Therapist, or Physiotherapist. A plaster mold is usually made of the feet and the orthotic is then fashioned. Using orthodics inappropriately can also make foot problems worse.

• Heel pads can give relief. We routinely use the Spenco ¼ inch heel cup or similar support.

• Cortisone injections may be tried if conservative treatment does not work.

• Night time foot splints can be built or bought over the counter, to help stretch the Achilles tendon. This is not commonly used but still may be very effective as they help to passively stretch the plantar fascia during sleep.

• Surgical treatment for Plantar Fascitis is very rarely done.

• Athletic taping of the arch of the foot is a useful modality to give extra support. This takes off some of the pressure off the fascia during walking and activity.

Aggravating conditions that predispose to developing plantar fascitis include:

• Flat pronated feet (pes planus)

• High arched feet (pes cavus)

• Overuse (direct trauma)

• Old or poorly fitting shoes

• Lack of Achilles tendon flexibility

Exercise to improve flexibility and support the foot arch are the mainstay of treatment and should be started soon in rehabilitation. It is important to be followed by a good therapist who can ensure you follow the correct exercises. Doing exercises wrong is a waste of time.

Simple exercises include: