Summer Blog Series: Plantar Fasciitis

July 10, 2012 Posted by Dr.Chang

This Summer we will be doing  a blog series on common foot and ankle injuries and conditions starting with one of the most popular that we see in out office- Plantar Fasciitis.

Researchers estimate that the front of your foot absorbs three to four times your body weight with each stride as you run. With an average of 1500 strides per mile, runners and athletes can put considerable stress on their feet. Moreover, feet have complex structures, each containing 26 bones, 33 joints , 112 ligaments, not to mention the additional tendons, nerves and blood vessels. Runners and athletes may suffer from a multitude of injuries and conditions in their ankles and feet, which Dr. Kevin Murray and Dr. Stewart Chang have years of experience diagnosing and treating. Glossed below are summaries of the most common podiatric running injuries, including brief explanations, diagnostic techniques, and treatment and rehabilitation strategies.

 Plantar Fasciitis

A common, yet no less painful, injury, plantar fasciitis refers to the inflammation of the plantar fascia, the connective tissue that runs along the bottom of the foot and creates the arch of the foot. The plantar fascia helps to support the arch of the foot, taking pressure off the arch when the foot bears weight. Experts suggest that the plantar fascia supports up to 14% of the pressure exerted on the foot. During activity, the plantar fascia acts like a spring, propelling us forward as we take steps.

Inflammation of the plantar fascia is called plantar fasciitis, and occurs when the plantar fascia is over stretched or over used. Causes include foot arch problems, obesity or sudden weight gain, long-distance running, especially running downhill or on uneven surfaces, a tight Achilles tendon, and shoes with poor arch support or soft soles. Plantar fasciitis is one of the most common injuries treated among the running population.

Plantar fasciitis is frequently diagnosed in men between ages 40 and 70 years, however, it is such a common podiatric injury that it is seen across the board with various age groups and genders. The symptoms of plantar fasciitis include pain and stiffness in the bottom of the heel, which can be either dull or sharp, ache or burn. Patients commonly complain that the worst pain is felt in the morning, but also after standing or sitting for long durations, while climbing stairs or after intense activity.

Here is the unfortunate catch to plantar fasciitis: while it does not hurt during activity, activity is exactly what causes the pain. Plantar fasciitis will hurt during recovery from a workout, or after waking up in the morning. Despite not hurting during running or activity, be aware that running only causes further damage to the plantar fascia. The cold, hard truth of the matter is that you cannot run through plantar fasciitis – running will only make your injury worse.

Diagnosis and treatment for plantar fasciitis vary. You can expect your podiatrist to perform a physical exam to provide clues from your foot’s physiology – flat feet or high arches, for example. Tenderness in the bottom of the foot, mid-foot swelling, redness, and stiffness are indicators of plantar fasciitis. Your podiatrist may also take X-rays to rule out other problems. Treatment regimens include taking non-steroidal anti-inflammatory meds (NSAIDs), such as Ibuprofen, Advil, Motrin, or Aleve, that work by blocking enzymes that stimulate swelling to reduce pain caused by inflammation, heel stretch exercises, mid-foot massage, plenty of rest, and ensuring that you are wearing supportive and cushioned shoes. Applying ice at least twice a day for 15 minutes at a time will help reduce inflammation and pain, and padding such as heel cups, foot pads, shoe inserts and custom made orthotics will help everyday activity. Night splits will enable your plantar fascia to stretch and heal, and let you get up in the morning pain free. In more severe cases, boot castes may be prescribed, and even steroid shots or injections may be given. If pain continues, in very extreme cases, your podiatric surgeon may suggest surgical methods.

In general, to prevent plantar fasciitis, make sure your ankle, Achilles tendon and calf muscles are flexible. Please visit the Heel Pain Center of Virginia on the web for more information on Plantar Fasciitis and other injuries to the heel.

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