The plantar fascia is a thickened fibrous aponeurosis that originates from the medial tubercle of the calcaneus, runs forward to insert into the deep, short transverse ligaments of the metatarsal
heads, dividing into 5 digital bands at the metatarsophalangeal joints and continuing forward to form the fibrous flexor sheathes on the plantar aspect of the toes. Small plantar nerves are invested
in and around the plantar fascia, acting to register and mediate pain.
The most common cause of plantar fasciitis relates to faulty structure of the foot. For example, people who have problems with their arches, either overly flat feet or high-arched feet, are more
prone to developing plantar fasciitis. Wearing non-supportive footwear on hard, flat surfaces puts abnormal strain on the plantar fascia and can also lead to plantar fasciitis. This is particularly
evident when oneâs job requires long hours on the feet. Obesity may also contribute to plantar fasciitis.
The symptoms of plantar fasciitis include pain in the bottom of your foot, especially at the front or centre of the heel bone, pain that is worse when first rising in the morning (called "first-step
pain"), when first standing up after any long period of sitting, or after increased levels of activity especially in non-supportive shoes. Seek medical advice about plantar fasciitis if you have heel
pain or pain in the bottom of your foot, especially when you get up in the morning, that does not respond to treatment or if there is redness or bruising in the heel.
A health care professional will ask you whether you have the classic symptoms of first-step pain and about your activities, including whether you recently have intensified your training or changed
your exercise pattern. Your doctor often can diagnose plantar fasciitis based on your history and symptoms, together with a physical examination. If the diagnosis is in doubt, your doctor may order a
foot X-ray, bone scan or nerve conduction studies to rule out another condition, such as a stress fracture or nerve problem.
Non Surgical Treatment
The following self-help treatments have been found to be most effective. Rest your foot. Reduce the amount of weight-bearing activities you participate in. Get off of your feet and elevate them. This
will allow healing to begin. Apply ice to your foot. Applications of ice packs that provide a comfortable cooling to the heel and arch (not a freezing cold) will help reduce pain, swelling, and
inflammation. Apply the ice to the heel and arch (not the toes). Make sure it is comfortable, and leave on your foot for about 20 minutes, 3 times a day. If you have any medical problems such as
diabetes, poor circulation, etc., discuss the use of ice with your doctor before applying the ice. ActiveWrap allows you to apply comfortable cold therapy to your foot without messy ice cubes. Use
while on the "go." Do not walk with bare feet. Always protect your heels, arches, and plantar fascia with good supportive shoes. Orthaheel Orthotic Flip Flops For Men and Women are designed for
walking comfort with built in orthotic footbeds that help reduce foot pain from plantar fasciitis. Use in the house or on the beach. Stretch the Plantar Fascia while sleeping. Plantar Fasciitis and
Heel Spur pain is usually worse with the first steps in the morning. This is due to the Plantar Fascia tightening up, or contracting while we sleep. To prevent these pain producing contractures of
the plantar fascia, the foot must be held in its normal or neutral position while we sleep. This optimal position of the foot is maintained with our comfortable and supportive Night Splint. When foot
contractures are prevented during sleep, the "first step pains" Plantar Fasciitis and Heel Spurs will gradually subside. Stretch the Plantar Fascia during the day. Even though the Plantar Fascia is a
thick tissue band with very little "give" to it, with the proper care (a Night Splint and the following exercises) it can be stretched a small amount. By stretching the Plantar Fascia even a bit, its
abnormal pull on the heel is reduced. This will help to reduce pain and inflammation in the heel and arch. Two of the most effective exercises recommended are. Before stepping down, especially after
sleeping or resting, stretch the arch of the foot by stretching your legs out in front of you (do not bend the knee). Place a towel around the ball of the foot. Slowly pull on the ends of the towel,
pulling the toes and ball of the foot back as far as is comfortable. Hold the foot in this position for ten seconds. Repeat at least ten times. You should feel a pull on the bottom of the foot,
especially in the arch. This stretches the plantar fascia, and reduces its pull on the heel. Stand about 2 to 3 feet from a wall. Lean forward with your hands against the wall. With the painful foot
behind, place the other foot forward. Press against the wall, shifting weight over the front foot, while straightening the back leg. Keep the heel of the back foot on the floor and feel the stretch
in the heel, Achilles tendon, and calf. Hold this position for ten seconds. Repeat at least ten times, and try to do this three times a day. When these things are achieved, the inflammation and pain
of Plantar Fasciitis and Heel Spurs will gradually subside. If you are unsure of the nature of your foot problem, if your pain is intense and does not subside, if you are a diabetic or have other
medical problems, if your pain is due to an injury, if an open sore is present, if a mass can be felt, or if you think that you may have an infection, we suggest that before beginning any of the
above treatments you consult with your doctor.
Surgery is rarely needed in the treatment of plantar fasciitis. The vast majority of patients diagnosed with plantar fasciitis will recover given ample time. With some basic treatment steps, well
over 90% of patients will achieve full recovery from symptoms of plantar fasciitis within one year of the onset of treatment. Simple treatments include anti-inflammatory medication, shoe inserts, and
stretching exercises. In patients where a good effort with these treatments fails to provide adequate relief, some more aggressive treatments may be attempted. These include cortisone injections or
extracorporeal shock wave treatments.