> Plantar Fasciitis
What is the Plantar Fascia?
The plantar fascia is the fibrous tissue on the bottom
of your foot that connects the heel bone (calcaneous)
to the toes. When you bend your toes, you can feel the
plantar fascia tighten along the bottom of your foot.
It maintains the shape of your foot's arch and helps
ensure you have a normal gait when walking or running.
When standing, the plantar fascia is tightened and helps
form the arch of your foot. At the beginning of each
step, the heel lifts up and the plantar fascia tightens
in the shape of your arch, allowing you to push off
with your toes.
Tears in the plantar fascia tissue result in the condition
called plantar fasciitis. It can cause chronic pain
in the arch, usually close to the heel, and is sometimes
called heel pain syndrome. Plantar fascia tears most
often occur where the tissue inserts in the heel bone,
but they may occur anywhere along the bottom of your
foot. The heel pain caused by plantar fasciitis is a
common sports injury that can be be irritating and hinder
your ability to perform.
Plantar fasciitis is commonly caused
by overuse or increasing the intensity of your activities
or sports. You may be at particular risk for developing
plantar fasciitis if you begin a new activity after
a period of inactivity. Simply spending too much time
on your feet can increase your chances of suffering
plantar fasciitis, especially if your job requires many
hours of walking on a hard surface. Sports that require
running or jumping on hard surfaces, like sprinting,
ballet dancing, and basketball, commonly cause plantar
fasciitis. Jogging and walking can also put added strain
on the plantar fascia. The normal aging process decreases
some of the plantar fascia's elasticity or resilience,
which may put older people at greater risk for developing
heel pain during less stressful activities. Unpadded
or worn-out footwear may increase the strain to your
plantar fascia. Biomechanical faults in the shape of
your foot or the strength of your leg muscles often
put too much stress on the plantar fascia. Feet with
either flat or high arches are more likely to suffer
plantar fasciitis. Having weak muscles in the calf,
toes, or ball of your foot can hinder your ability to
absorb shock when walking or running, which can place
extra tension on the plantar fascia. Excess body weight
also increases the strain on the plantar fascia.
fasciitis is a common cause of heel pain, your physician
may need to rule out less common causes like nerve compression,
stress fractures in the heel bone, or loss of the fatty
tissue that pads the bottom of your heel. Plantar fasciitis
often causes small bony growths called heel spurs. Because
the plantar fascia is connected to many tendons in the
foot, many people also suffer from plantar fasciitis
and tendinitis at the same time. The treatment for plantar
fasciitis, heel spurs, and tendinitis is often the same.
If left untreated, your heel pain may continue to worsen.
In general, the longer you wait to seek treatment for
your heel pain, the longer it takes to cure. You should
visit your physician as soon as you notice heel pain
to receive the most effective treatment. Conservative,
non-surgical treatment helps cure about 90 percent of
patients with plantar fasciitis. Mild to moderate cases
are often treated with ice, stretching, and shoe modification.
Severe plantar fasciitis may require splints to immobilize
the foot and possibly cortisone injections to reduce
inflammation in the tissue. Successful treatment often
takes months to cure plantar fasciitis, especially in
athletes that overuse their feet, like cross-country
and marathon runners.
There are usually three
parts to an orthopedic evaluation: medical history,
a physical examination, and tests that your doctor may
Your physician likely will ask about your activities,
which may be causing the pain in your heel. He will
probably ask when the soreness or pain began. If you
have had any prior foot injuries, your physician will
ask about the treatments you have tried in the past.
Physicians also typically ask about other conditions,
such as diabetes and allergies, and medications currently
being taken. You may also be asked about your physical
and athletic goals information that will help
your physician decide what treatment might be best for
you in achieving those goals.
Physicians can often diagnose plantar fasciitis by
putting direct pressure on the bottom of your heel.
The heel is usually tender when pressure is applied
and pain tends to increase when your toes and foot are
bent upward. Your physician usually individualizes your
treatment by evaluating the shape of your foot and the
biomechanics of your stride.
X-rays are sometimes used if your physician suspects
you have bone spurs. MRI
(magnetic resonance imaging) is infrequently used to
check for abnormally large amounts of fluid, called
edema, in the plantar fascia.