Plantar fasciitis causes pain in the bottom of the heel. The plantar fascia is a thin ligament that connects your heel to the front of your foot. It supports the arch in your foot and is important in
helping you walk. Plantar fasciitis is one of the most common orthopedic complaints. Your plantar fascia ligaments experience a lot of wear and tear in your daily life. Normally, these ligaments act
as shock absorbers, supporting the arch of the foot. Too much pressure on your feet can damage or tear the ligaments. The plantar fascia becomes inflamed, and the inflammation causes heel pain and
Causes can be by one or a combination of foot activity overloads. Jogging, climbing, or walking for extended periods puts too much stress on the plantar fascia. But even routine, non-athletic
activities such as moving heavy furniture can set off pain. Some kinds of arthritis are also attributed to plantar fasciitis. Certain arthritic conditions cause the tendons of the heel to swell.
Diabetes is also a culprit- there is still no explanation why, but studies have repeatedly shown that diabetics are more prone to developing plantar fasciitis. In some cases, plantar fasciitis is
triggered by shoes of poor quality or shoes that do not fit. Those with thin soles, no arch support, and no shock-absorbing properties, for example, do not five feet enough protection. Shoes that are
too tight and those with very high heels can also cause the Achilles tendon to tighten, straining the tissue surrounding the heels.
The classic sign of plantar fasciitis is that the worst pain occurs with the first few steps in the morning, but not every patient will have this symptom. Patients often notice pain at the beginning
of activity that lessens or resolves as they warm up. The pain may also occur with prolonged standing and is sometimes accompanied by stiffness. In more severe cases, the pain will also worsen toward
the end of the day.
If you see a doctor for heel pain, he or she will first ask questions about where you feel the pain. If plantar fasciitis is suspected, the doctor will ask about what activities you've been doing
that might be putting you at risk. The doctor will also examine your foot by pressing on it or asking you to flex it to see if that makes the pain worse. If something else might be causing the pain,
like a heel spur or a bone fracture, the doctor may order an X-ray to take a look at the bones of your feet. In rare cases, if heel pain doesn't respond to regular treatments, the doctor also might
order an MRI scan of your foot. The good news about plantar fasciitis is that it usually goes away after a few months if you do a few simple things like stretching exercises and cutting back on
activities that might have caused the problem. Taking over-the-counter medicines can help with pain. It's rare that people need surgery for plantar fasciitis. Doctors only do surgery as a last resort
if nothing else eases the pain.
Non Surgical Treatment
There are several things you can do to self-treat your heel or arch pain. The first thing is to wear better shoes and consider adding arch supports or custom foot orthotics to your shoes. Stretching
the calf muscles can also often be helpful. Try to stretch when you first get up in the morning and before you go to bed at night. Another good exercise is to "roll" your arch and heel. This is done
by placing a tennis ball, golf ball, or lacrosse ball on the floor and rolling your foot on top of it. Some people get extra benefit by "rolling" on a frozen water bottle. You should also carefully
evaluate your fitness program as you may be overdoing it. You may want consider backing of new or recently added exercises or increases in training until your heel pain improves. If you work at a
standing job try to take more time to walk around during the day and avoid standing in one place for too long.
Surgery is considered only after 12 months of aggressive nonsurgical treatment. Gastrocnemius recession. This is a surgical lengthening of the calf (gastrocnemius) muscles. Because tight calf muscles
place increased stress on the plantar fascia, this procedure is useful for patients who still have difficulty flexing their feet, despite a year of calf stretches. In gastrocnemius recession, one of
the two muscles that make up the calf is lengthened to increase the motion of the ankle. The procedure can be performed with a traditional, open incision or with a smaller incision and an endoscope,
an instrument that contains a small camera. Your doctor will discuss the procedure that best meets your needs. Complication rates for gastrocnemius recession are low, but can include nerve damage.
Plantar fascia release. If you have a normal range of ankle motion and continued heel pain, your doctor may recommend a partial release procedure. During surgery, the plantar fascia ligament is
partially cut to relieve tension in the tissue. If you have a large bone spur, it will be removed, as well. Although the surgery can be performed endoscopically, it is more difficult than with an
open incision. In addition, endoscopy has a higher risk of nerve damage.
Being overweight can place excess pressure and strain on your feet, particularly on your heels. Losing weight, and maintaining a healthy weight by combining regular exercise with a healthy, balanced
diet, can be beneficial for your feet. Wearing appropriate footwear is also important. Ideally, you should wear shoes with a low to moderate heel that supports and cushions your arches and heels.
Avoid wearing shoes with no heels.