Conditions - Plantar Fasciitis
What is it?
The plantar fascia is a broad band of fibrous tissue that runs along the bottom surface of the foot, attaching at the bottom of the heel bone and extending to the toes. Plantar fasciitis is an inflammation caused by excessive stretching of the plantar fascia causing micro-tears in the tissue.
Individuals who suffer from plantar fasciitis often complain that their first steps out of bed in the morning are very painful. The pain may subside with activity, but worsen again at the end of the day or after sitting for a period of time and then getting up again.
With Plantar fasciitis, the bottom of your foot usually hurts near the inside edge where the heel and arch meet. You may also commonly experience pain along the inside edge of your foot between the heel and the ball of your foot.
What causes it?
Plantar fasciitis is usually an overuse injury that can be caused by:
- Over-pronation (which results in the arch collapsing upon weight bearing and over-stretching the fascia);
- A foot with a high arch (which results in an inflexible foot that does not absorb shock well);
- A sudden increase in physical activity;
- Excessive weight on the foot (sudden weight gain as in pregnancy);
- Tight calf muscles (which decreases the ankle’s flexibility and increases the strain on the plantar fascia);
- Poor footwear (which does not help to control the foot’s mechanics or is too rigid).
How can a pedorthist help you treat it?
The key for the proper treatment of plantar fasciitis is determining what is causing the excessive stretching of the plantar fascia. When the cause is over-pronation (common with a low-arched foot), an orthotic with rearfoot posting and longitudinal arch support is an effective device to reduce the over-pronation and allow the condition to heal.
If the cause is your unusually high arches, an orthotic that provides cushioning and stability to the foot as well as footwear that will complement your rigid foot type (a good shock absorbing shoe) will be of most benefit.
Stretching of the calf muscle is, surprisingly, a key component to helping treat plantar fasciitis. It is particularly useful in reducing the early morning pain or pain when getting up from rest. The calf should be stretched gently before getting up in the morning to reduce daily re-injury.
Other common treatments include plantar fasciitis night splints and shoes with strong heel counters to control the amount of pronation and provide good cushioning to the foot. A shoe with a good rocker sole at the toes can also be helpful in reducing the strain on the plantar fascia. Heel pads can help to provide extra comfort and cushion the heel, but do not address the biomechanical abnormality that may be causing the pain and is often not a good long-term solution.
Avoid running on hard or uneven ground, lose any excess weight through a balanced exercise program.