A Professional View of Plantar Fasciitis

Heel pain is common in adults over the age of forty. This type of pain may be caused by plantar fasciitis which is inflammation of the very thick ligament that provides support to the soles of your feet and your arches.

When this ligament begins to wear out and lose its elasticity, you may find that you awaken to very severe pain in the soles of your feet when you get out of bed in the morning. Moving around may provide some relief to this problem, but if you have a job where you need to sit for long periods of time during the day you may find that the pain returns every time you stand up.

The most recognizable symptom of this condition is stabbing pain in the heel of your foot. If you tend to be on your feet a great deal or if you are a runner, this pain may go away while you are moving about but come back with a vengeance when you sit down.

What Can You Do?

If you wear proper, supportive footwear you may be less likely to feel the severe pain of plantar fasciitis. Other things that may help include:

Get up and walk around frequently throughout the day in your good shoes
Avoid excessive standing or punishing exercise
Participate in light to moderate exercise daily
Eat well and maintain a healthy weight
Get ample rest

Excessive stress on the foot caused by extreme exercise, poor health, excessive weight, and/or bad shoes can cause overstretching and tearing in the fascia. This causes the ligament to wear out with the passage of time.

Other Contributing Factors

If you already have problems with your feet such as:

Very High Arches
Flat Footedness
Abnormal Gait

…..you will be more likely to develop plantar fasciitis because all of these conditions put excessive stress on the soles of your feet.

Certain occupations tend to contribute to the development of this foot problem. Among them are:

Fast Food Work
Factory Work
Police Work
Teaching
Military
Nursing

Choose Your Form of Exercise Carefully

Be sensible. Weekend warriors who live a mostly sedentary life and then go all out with very challenging physical activities are far more likely to experience injuries of all kinds.

Some types of exercise are more likely to cause plantar fascia than others. For example:

Long-Distance Running
Ballistic Jumping
Aerobic Dance
Ballet Dancing

All of these put excessive stress on the plantar fascia and may contribute to the development of this problem.

What Should You Do About Plantar Fasciitis?

Plantar fasciitis is hard to ignore, but if you decide to tough it out without doing anything you're very likely to experience more severe pain in your feet and complications in terms of the alignment of the rest of your body. Ignoring Plantar fasciitis can cause problems with your ankles, knees, hips and back.

Remember that your feet are the foundation for the rest of your body, and if you're having problems they are you're very likely have problems elsewhere very soon. Make an appointment with your doctor right away for a diagnosis.

Your doctor may be able to make a firm diagnosis just based on a physical examination and your account of the pain. If not, he or she may order magnetic resonance imaging (MRI) or take an x-ray.

These diagnostic tests will allow your doctor to rule out pinched nerve or stress fracture as the cause of your pain. X-rays can also pick up bone spurs that may have developed in your heel because of plantar fasciitis. Sometimes removal of the bone spur will also resolve the rest of your pain.

Is Surgery Absolutely Necessary?

Most of the time, this problem can be resolved without surgery. If your plantar fasciitis does not need to be addressed by surgery, there are lots of very conservative treatments you can use.

Sometimes just taking over-the-counter pain relievers such as Motrin, Advil or Aleve can help resolve the inflammation and the pain. Even so, you should understand that use of pain relievers only masks the pain. It's a good idea to also address the problem with diet, exercise and proper footwear.

In addition to these home remedies, your doctor may recommend some other therapies, such as:

Your doctor may give you a referral to a physical therapist to help you learn how to exercise your feet, ankles and legs for greater stability and flexibility. Your therapist may also teach you how to tape the soles of your feet for more support.
Your doctor or your physical therapist may prescribe a night splint to help stretch your calves and the arches of your feet while you're sleeping. This type of splint will hold your Achilles tendons and Plantar fascia in an extended position as you sleep. This helps eliminate the problem of painful feet upon arising and also helps heal your damaged fascia.
Your doctor may make recommendations for over-the-counter shoe inserts and/or he or she may also prescribe custom fitted orthotic arch supports for you. Both bespoke orthotics and over-the-counter supports can help relieve the pain of plantar fasciitis by distributing your weight more evenly across the soles of your feet.

What If Conservative Treatments Don’t Work?

If you try these solutions for several months without obtaining significant relief, your doctor may try one of these procedures:

Steroid injections into the painful areas of your feet can provide pain relief. It's not a good idea to repeat this process very often because it will eventually weaken the plant are fascia and worsen the problem; however, it is a good idea to help relieve severe pain.
Injections of platelet rich plasma may also be helpful. Your doctor will use ultrasound to pinpoint the locus of your pain, inject plasma in an extremely focused way. As with steroids, it's not a good idea to do this on a repeated basis but it can help to relieve extreme pain.
Your doctor may try to stimulate healing through extracorporeal shockwave therapy. With this type of therapy sound waves will be directed into the painful area of your heel. This treatment for chronic, painful plantar fasciitis is not without side effects. It may cause numbness and tingling, pain, swelling and even bruising. Even so, once healing from the treatment is complete, the plantar fasciitis may also be healed.
Your doctor may try to remove the scar tissue from your plantar fascia through a very minimally invasive procedure called Tenex FAST procedure. This in-office treatment involves local anesthesia, one or two small incisions and the use of ultrasonic energy to break up and remove dead tissues that may be causing pain.
If all else fails, it may be necessary to remove the plantar fascia from your heel bone via surgery. This is a very invasive and potentially damaging procedure that may end up weakening your arches. Your doctor will only recommend this as a last option.

It's easy to see that it's much better to try to avoid plantar fasciitis than to have to treat it, especially in an aggressive manner. Luckily, it's easy to avoid or at least minimize the development of plantar fasciitis by maintaining a healthy weight, wearing good shoes, participating in light-to-moderate exercise on a regular basis and resting as needed.

Develop the habit of stretching your arches, ankles and calves every morning when you get up and every night before you go to bed. These types of exercises are easy to do while you're relaxing in front of the television.

Whenever you feel pain in your feet, ankles or lower legs use simple, commonsense home treatments such as massage, ice, elevation and rest to relieve your symptoms.