If you feel pain on the bottom of your feet, your plantar fascia may be inflamed.
Inflammation or irritation of this thick band of tissue which connects heel bone (calcaneus) to the toes can cause pain, swelling, and stiffness in one or both heels. This condition is called Plantar Fasciitis.
We are going to discuss the plantar fasciitis symptoms, causes, types and treatments available for heel and plantar fascial pain in this article.
What Exactly Is Plantar Fasciitis?
Plantar Fasciitis is an inflammation of the fat pad on the bottom of the foot. A thickening or tightness of the muscles of the calf such as the Gastrocnemius Muscle and Soleus can pull into the plantar fascia, causing irritation, arch pain and heel pain.
When there is irritation of the thick plantar fascia, it results in a condition called plantar fasciitis, which is classified as sharp heel pain over the heel bone with standing and weight bearing activities.
Plantar Fascia Inflammation Types
Plantar Fasciitis is usually categorized into two types/phases during each, patients may have different experiences:
Acute Plantar Fasciitis
During the acute phase of plantar fasciitis, the patient may experience mild discomfort. Pain is worse first thing in the morning or after long periods of rest, decreasing as the patient becomes more active throughout the day.
Treating plantar fasciitis during the initial phase is very beneficial for the patient as the inflammation can be controlled before it progresses.
Chronic Plantar Fasciitis
During the chronic phase of plantar fasciitis, the patient may experience constant pain with weakness, muscle atrophy, decrease in quality of life and not be able to perform certain activities at all or for a certain duration.
At this point, the fat pad starts to thicken and the risk of bone spurs may start to develop.
Common Causes of Plantar Fasciitis
The mechanics of the foot are critical as your feet are the foundation for your body and support your full body weight in standing. All these factors listed below can be common causes of plantar fasciitis and can contribute to increasing the risk of developing this condition.
- Being flat foot or having collapsed arches.
- Having too high of an arch.
- Having an atypical gait due to low back pain or hip pain.
- Being overweight.
- Previous history of ankle sprains and strains.
- Previous foot injury of broken bones.
Symptoms of Plantar Fasciitis
Most patients experience stabbing-like pain in the morning, first thing when getting out of bed.
This is because the fat pad on the bottom of the foot has had time to rest so during the initial phase of gait, the weight bearing adds pressure resulting in pain.
Plantar fascia is a structure designed to support the arch of the foot and absorb shock during activity.
These People Are at Risk of Getting Plantar Fascia Inflammation
Individuals who are at high risk for Plantar Fasciitis are those who tend to stand for long periods of time on hard surfaces whether it’s due to their job or lifestyle.
Being overweight is another risk factor as the extra weight can often shift the center of gravity in your body, putting extra stress on ligaments that aren’t strong enough to support that shift.
Athletes are highly targeted with this condition, especially if they are involved in activities such as running, sprinting or standing for long periods of time. This is due to prolonged tension on the fascia, which may lead to microtearing resulting in inflammation.
How Plantar Fasciitis is Diagnosed?
Plantar Fascia is classically diagnosed based on patient presentation and symptomatology. The gathered information is required to provide the best treatment for plantar fasciitis.
Medical professionals such as medical doctors, physiotherapists and chiropractors are all trained to diagnose plantar fascia based on its presentation and conservative therapy is always recommended first before considering other more invasive therapies.
X-rays can help determine presence of heel spurs that could be contributing to the heel pain and ultrasound or MRI can further assess the tissue integrity.
Although imaging modalities may help us understand bony malformations, they are not very definitive in providing a diagnosis for plantar fasciitis and this condition is primarily diagnosed through interviewing the patient and asking about specific symptoms that they may be experiencing.
Treatment Options for Plantar Fasciitis
As discussed before, plantar fasciitis is a common condition that involves inflammation of the plantar fascia, a thick band of tissue that runs along the bottom of the foot, connecting the heel bone to the toes.
This condition can be effectively treated through a combination of therapies. From manual therapy, to surgery and medications, there are various plantar fasciitis treatments available.
Consulting a healthcare provider is crucial for developing a personalized treatment plan.
Here are some common treatment options for plantar fasciitis:
- Regular Exercise
- Chiropractic Shockwave Therapy
- Foot Orthotics
- Massage Therapy
Each of these treatments will be discussed more.
If the pain is not within one’s pain threshold, consuming the recommended dosage of NSAIDS such as Ibuprofen may help decrease the pain and inflammation you are experiencing.
This is recommended as a short term solution and is not intended to be used for chronic plantar fasciitis.
Performing exercises such as stretching or strengthening can overall improve your condition. Taking the time throughout your day to perform calf stretches to relax the lower posterior compartment muscles of the leg will help eliminate some of the tension that is radiating into the heel of the foot.
As far as strengthening goes, performing towel scrunches with your toes will help support the plantar fascia and overall build endurance.
Shockwave Therapy is a noninvasive procedure which consists of using high-energy waves to stimulate healing in the heel.
Although it can be initially painful, this form of therapy is performed in many sessions, resulting in decreased pain and increased functionality. This service can be provided by physiotherapists.
Orthotics is meant for collapsed arches, commonly known for flat feet. They are shoe inserts that contribute in additional support and cushioning of the plantar aspect of the foot.
By using custom foot orthotics as shoe inserts, they alleviate pain and discomfort when performing activities such as walking or running. The unique aspect of these inserts are that they are designed to be accustomed to fit you and your feet so on every patient, they look and fit differently.
Orthotics can be prescribed by a podiatrist or orthopedic specialist such as chiropractors.
Massage is another beneficial way to help. Registered Massage Therapists (RMTs) work with the tissue itself. There are so many muscular structures attaching the leg and the foot together as the whole body is connected.
Massage Therapists work with specific or a certain group of muscles, ligaments and tendons
Cortisone Shot Injections
Cortisone injections are great at reducing inflammation of the plantar fascia and this therapy tends to result in significant pain relief for the first 3-6 months. However, there is a chance that pain can return once the effect of the shot starts to wear off.
Surgery is definitely a last resort to this condition, it consists of cutting the plantar fascia to decrease swelling and help with overall tension buildup.
Commonly, patients take 3-6 weeks to recover but are not able to run or jump for 3 months post surgery. You will work actively in rehab as your doctor provides you with stretching and strengthening exercises.
Plantar fasciitis is one of the more common conditions affecting the foot. Furthermore, plantar fasciitis is a condition that can develop from a foot injury or a foot trauma that precedes this condition.
Therefore, if you have had a foot injury, ankle sprains or any type of foot pain, it is important to address the issue and seek appropriate rehab for the condition to avoid further complications and development of plantar fasciitis in the future.