Plantar fasciitis is a painful condition causing heel pain and many people with the condition also have heel spurs. It affects the band of tissue (plantar fascia) that supports the middle part of the
foot and runs along the sole of the foot from the heel to the ball of the foot. Usually the plantar fascia is strong and flexible but due to certain factors it can become irritated and inflamed where
the plantar fascia joins the bone in the foot. Heel spurs occur when there's constant pulling of the fascia at the heel bone. This leads to a bony growth or spur. The symptoms of plantar fasciitis
are pain in the arch of the foot or heel. This pain is usually worse in the morning after rest when the plantar fascia tightens and shortens. Heel spurs cause a stabbing pain at the bottom or front
of the heel bone.
The cause of plantar fasciitis is often unclear and may be multifactorial. Because of the high incidence in runners, it is best postulated to be caused by repetitive microtrauma. Possible risk
factors include obesity, occupations requiring prolonged standing and weight-bearing, and heel spurs. Other risk factors may be broadly classified as either extrinsic (training errors and equipment)
or intrinsic (functional, structural, or degenerative). Training errors are among the major causes of plantar fasciitis. Athletes usually have a history of an increase in distance, intensity, or
duration of activity. The addition of speed workouts, plyometrics, and hill workouts are particularly high-risk behaviors for the development of plantar fasciitis. Running indoors on poorly cushioned
surfaces is also a risk factor. Appropriate equipment is important. Athletes and others who spend prolonged time on their feet should wear an appropriate shoe type for their foot type and activity.
Athletic shoes rapidly lose cushioning properties. Athletes who use shoe-sole repair materials are especially at risk if they do not change shoes often. Athletes who train in lightweight and
minimally cushioned shoes (instead of heavier training flats) are also at higher risk of developing plantar fasciitis.
The most common symptom is pain and stiffness in the bottom of the heel. The heel pain may be dull or sharp. The bottom of the foot may also ache or burn. The pain is often worse in the morning when
you take your first steps, after standing or sitting for awhile, when climbing stairs, after intense activity. The pain may develop slowly over time, or come on suddenly after intense activity.
Your doctor will perform a physical exam to check for tenderness in your foot and the exact location of the pain to make sure that itâs not caused by a different foot problem. The doctor may ask
you to flex your foot while he or she pushes on the plantar fascia to see if the pain gets worse as you flex and better as you point your toe. Mild redness or swelling will also be noted. Your doctor
will evaluate the strength of your muscles and the health of your nerves by checking your reflexes, your muscle tone, your sense of touch and sight, your coordination, and your balance. X-rays or a
magnetic resonance imaging (MRI) scan may be ordered to check that nothing else is causing your heel pain, such as a bone fracture.
Non Surgical Treatment
Teatment of plantar fasciitis can be a long and frustrating process for both the coach and athlete. If you do not have a firm grasp of the goals of this rehabilitation program your best advice will
be to find a professional who routinely deals with athletic injuries. The "down time" for plantar fasciitis will be at least six weeks and up to six months of conservative care before drastic
measures like surgery should be considered. The goal of this rehab program is to initially increase the passive flexion of the foot eventually leading to improvements in dynamic balance and
flexibility of the foot and ankle, followed by a full return to function.
Surgery is usually not needed for plantar fasciitis. About 95 out of 100 people who have plantar fasciitis are able to relieve heel pain without surgery. Your doctor may consider surgery if
non-surgical treatment has not helped and heel pain is restricting your daily activities. Some doctors feel that you should try non-surgical treatment for at least 6 months before you consider
surgery. The main types of surgery for plantar fasciitis are Plantar fascia release. This procedure involves cutting part of the plantar fascia ligament . This releases the tension on the ligament
and relieves inflammation . Other procedures, such as removing a heel spur or stretching or loosening specific foot nerves. These surgeries are usually done in combination with plantar fascia release
when there is lasting heel pain and another heel problem. Experts in the past thought that heel spurs caused plantar fasciitis. Now experts generally believe that heel spurs are the result, not the
cause, of plantar fasciitis. Many people with large heel spurs never have heel pain or plantar fasciitis. So surgery to remove heel spurs is rarely done.
While there are no sure ways to prevent plantar fasciitis, these prevention tips may be helpful. Keep your weight under reasonable control. Wear comfortable, supportive shoes. Use care when starting
or intensifying exercise programmes.