Plantar Fasciitis
Do you wake up in the morning with pain in the heel? Do you have pain in the heel when you get up from a chair after sitting down for awhile? If you do, then you could be suffering from a condition called plantar fasciitis.
Plantar fasciitis is an inflammation of a ligament under the bottom of the foot. The ligament gets inflamed and becomes painful. The pain is usually a sharp ache with a feeling that the bone is bruised.
Causes of Plantar Fasciitis
The main cause is abnormality in the biomechanics of the foot. Meaning the foot rolls inward, causing the heel bone to turn outward. This leads to an excessive stretch on the ligament.
So, why did it happen all of a sudden and not several years ago? One reason is if a person is sedentary and then starts to increase their activity too quickly. Recent weight gain is another reason as is wearing improper shoes, like floppy sandals or shoes that do not support the foot. This is because the arch is flattening in these type of shoes, which causes the Plantar Fascia to stretch, causing the injury where it attaches to the heel bone. People who have very thin feet, with a lack of heel fat pad is another cause of plantar fasciitis.
If it sounds like you have this condition, the first thing to do is to rest your foot as much as you possibly can. Use the acronym, RICE; Rest, Ice, Compression, and Elevation. Ice the heel 3 x a day for 15-20 minutes. Definitely ice the area at the end of the day. You can see if compression, like using an ace bandage or ankle support, that covers the heel will help. An over the counter innersole or gel heel cushion might help. Try to wear a good athletic shoe or a shoe with a closed back. Women sometimes feel that a shoe with a 1-1.5 inch heel helps. This is because pressure is being relieved off the heel. If you can take anti-inflammatories, then you can take Advil to reduce the swelling. Pain, remember, is due to the inflammation.
If your symptoms are not relieved in two weeks, then it is best to see a podiatrist. Your podiatrist will go through a complete examination, including x-rays. During the examination, the doctor will assess your circulation and neurological status. This is to rule out all other causes of heel pain. The podiatrist will also assess your gait.
If the diagnosis is plantar fasciitis, the podiatrist may give you an injection of an anti-inflammatory. Treatment has to consist of treating the inflammation as well as the cause, the excessive tension on the plantar fascia. Taping the foot helps with the tension. Stretching exercises is a must but might not be performed until after some of the pain quiets down. Prescription anti-inflammatories, use of a night splint, physical therapy might also be needed.
The key to the cure of the plantar fasciitis is the use of an orthotic. Depending on the foot type, an accommodative orthotic, like a Lynco might be all that is necessary. However, in most situations, a custom orthotic will take care of the problem 95% of the time. That is because an accommodative orthotic functions more like a cushion. It does not give complete control of the foot as compared to something that is made for you. Remember, no two feet are alike, not even yours. So, people with thin feet or a foot that does not need a lot of control, can be helped with the accommodative type (meaning it accommodates your foot as compared to a device that corrects your foot).
After receiving an orthotic, the patient will need to see the podiatrist to see if adjustments to the device are necessary. The key is not only to treat but to prevent this condition from occurring again.
