What is plantar fasciitis?
Plantar Fasciitis is a repetitive stress injury to the plantar fascia on the bottom of the foot. The fascia runs from the heel toward the toes and helps support the body weight. Standing, running, or jumping increases the force and strain on the plantar fascia. Performing these motions causes more injury.
What are the symptoms?
Plantar Fasciitis is characterized by sharp stabbing pain on the bottom of the foot, often experienced with the first step out of bed in the morning. The pain will gradually decrease in several minutes but will frequently return after standing or sitting for long periods of time. Generally speaking, one feels tenderness on the inside of the heel and swelling on the bottom of the foot. The pain will disappear during activity but quickly returns afterwards.
It tends to take months to heal because of persistent agitation from standing and walking every day. It is hard to avoid standing, especially with some carers. Some professions require continuous standing, which tend to produce slow recovery and a tendency for long term problems. It is not uncommon for plantar fasciitis to affect people for 3 to 9 months.
What are the causes and risk factors?
Plantar Fasciitis is common in people who are physically active or spend significant time on their feet. Runners and joggers are sooner to plantar fasciitis, especially if they have recently increased their running mileage or intensity. It is very common for salesman and nurses who spend long hours walking on hard floors.
Worn out shoes and bad shoes do not absorb pounding and stress like quality shoes. These results in increased physical stress on the plantar fascia, leading to injury. In Arizona, sandals and flip flops often aggravate plantar fasciitis.
Improper foot mechanics, over-pronation, high arches, flat feet, or poor walking mechanisms can increase the stress on the plantar fascia leading to damage and continuously aggravating plantar fasciitis.
It is more common in middle aged people, as years of wear and tear on the body begin to show. As we begin to carry a few extra pounds later in life, this further increases the stress on the fascia.
What are the treatments?
Treatment for plantar fasciitis is directed at decreasing the chronic inflammation of the plantar fascia, stretching tight muscles, and encouraging proper healing of the fascia. Rest and ice therapy are initial home treatments. Night splints and orthotics can be used to decrease stress and support the arch and fascia.
Active treatment involves physiotherapy to decrease inflammation of the plantar fascia through electrical stimulation and ultrasound. Stretching of the calves and hamstrings to reduce stress and improve walking mechanisms is a key component of therapy. Proper proprioceptive and foot strengthening exercises prescribed by your healthcare provider further strengthens the foot and decreases stress on the plantar fascia.
The difficulty in successfully raising plantar fasciitis involves the physiology of cycles of inflammation and healing. Cycles of stress, rest, stress, and rest often produces improper scar tissue formation on the fascia. The scar tissue is designed to create a temporary patch until the area can heal correctly. However, the foot often ends up with patches of scar tissue that become injured daily with standing and therefore the foot never heals correctly. This is a common reason people can end up with plantar fasciitis for months to years.
A very successful treatment that aims to break up the scar tissue and allows the plantar fascia to heal correctly is the Graston Technique, currently employed at Alpha Chiropractic. The Graston Technique involves instrument-assisted soft tissue mobilization to treat soft tissue fibrosis and chronic inflammation. The Graston Technique breaks up the scar tissue patches seen in plantar fasciitis and causes proper healing in those areas. Treatment increases the speed of healing and quickly reduces the sharp pain.
Plantar fasciitis is best treated early. The longer and more severe it becomes, the harder and more involved treatment becomes. Seek help from an experienced provider sooner than later.