“When I get up on a morning, I fraid to put mih feet down . . . cause I get this sharp pain trying to step off, and it happens again if I sit for a while!” This is the most frequent description of the ailment, one most persons aren’t even aware has a name. Plantar Fasciitis, pronounced (plan-tur fas-e-i-tis) is one of the most common, painful foot ailments clients come into the Clinic with. This is seen more in persons who are on their feet…standing or walking for long periods.
It consists of inflammation of a thick band of tissue called the plantar fascia; this runs along the bottom of your feet connecting from the heel bone to your toes. It has been researched and results have found that in approximately 70% of patients, a heel spur can be seen via x-ray. The pains associated with the condition usually decreases after a few minutes of getting off the bed or chair, but would return again on repeating the same activities.
The key ones are:
Pains, which develop gradually.
Pain in one foot, although it can occur in both feet simultaneously.
Terrible pains with the first few steps on a morning; can also occur when standing for long periods or on getting up from sitting.
A sharp pain, especially in the heel area.
Who Gets It and Why?
It tends to develop more in:
Middle aged men and women but can occur in all age groups.
Women, especially because of the strain placed on the tissue due to pregnancy or ill fitting shoes (especially high heels), your Achilles tendon can become strained.
Persons whose professions require long periods of standing or walking eg. teachers, field and factory workers, and waitresses, amongst others.
Persons who are overweight or rapidly gain weight.
Athletes, especially those in track and field.
- Persons who are involved in exercise and other activities that put excessive pressure on the heel and attached tissue, examples of these are intense aerobics, gymnastics and ballet dancing.
- Persons who are flat footed, have extremely high arches or have an abnormal gait (way of walking), which affects the weight distribution. These issues are considered faulty foot mechanics and put additional strain on the fascia tissue.
- The usual – persons wearing improper shoes. Shoes without built in comfort or shock absorbing support.
There are different treatment options in the same way that there are different levels of pain and discomfort. There is no telling how long or how effective a particular treatment option may be, although some provide greater guarantees than others. Some treatments give immediate relief, while others take a few months or in other cases more than a year for real relief to occur.
These may ease the pain and inflammation but aren’t equipped to treat the underlying problem.
Icing helps to reduce pain and discomfort and is best if done alongside exercises and stretches.
Whether you choose to go to an actual therapist or do your own home routine, exercises to stretch the plantar fascia, Achilles tendon and lower leg muscles are excellent.
Arch Supports (Orthotics)
Your orthopaedic specialist/chiropodist/podiatrist/foot health practitioner may prescribe custom fitted arch supports to help with alleviation of the pain, balance, and better weight/pressure distribution.
Cortisone (Steroid) Injections
These are sometimes administered to decrease the inflammation, however they are not necessarily the best option, given they can weaken the fascia and possibly lead to it rupturing. Another concern is the potential shrinking of the fatty pad covering the heel bone. While both concerns carry a small occurrence percentage, if it does happen it can worsen the problem. Remember, multiple injections are not advisable.
What to do when other treatment methods don’t work?
In a small number of cases (usually less than 5%), patients may not experience relief after trying the recommendations suggested. However, it is important that conservative treatments be performed for at least a year, before considering surgery. Time is very important in healing the plantar fasciitis pain; insufficient treatment before surgery may subject you to potential complications associated with the procedure. If these treatments fail, your doctor may consider surgery to loosen the plantar fascia, called a plantar fascia release.
Because the diagnosis of plantar fasciitis can be confused with tarsal tunnel syndrome, most surgeons advocate performing a tarsal tunnel release (or at least a partial tarsal tunnel release) along with the plantar fascia release. This surgery is about 80% successful in relieving pain, especially in the small group of patients who do not improve with conservative treatments.
Surgery is rarely needed though in the treatment of plantar fasciitis. The vast majority of patients diagnosed with it would recover given ample time. With some basic treatment steps, well over 90% of patients would achieve full recovery within one year.
In exploring the surgery option, the side effects include a weakening of the arch in your foot. Therefore, having a consultation with your orthopaedic surgeon and getting a second opinion is strongly advisable.
To ensure you don’t become a victim, ensure you:
Wear sensible shoes. Stay away from constantly wearing high heel shoes. Naturally as women, the height of the shoes matter, but let that be occasional rather than the norm.
Use low to moderate (2-2 ½’’) heels for work, with shock absorbency and good arch support. Walking barefooted is not an option.
Maintain a healthy weight; it reduces your chances of strain on the plantar fascia.
Your feet mirror your general health . . . cherish them!