What is Plantar Fasciitis? Plantar fasciitis is a common foot problem in sports participants and people that stand/walk for extended periods during the day. It starts as dull occasional pain in the heel which may progress to a sharp persistent pain. Classically, it is worse in the morning with the first few steps, or at the beginning of a sporting activity. The plantar fascia is a thick fibrous band running the length of the arch from the heel bone to the ball of the foot. It is responsible for helping maintain the arch of the foot. It stretches to help absorb shock as the arch flattens with body weight. With repetitive stress, such as prolonged standing, walking or running, the fascia becomes strained resulting in micro tears, most often where the fascia attaches to the heel bone. Since it is difficult to rest, a vicious cycle is set up where the situation is aggravated with each step. In severe cases, the heel may become swollen. The problem progresses rapidly and is much easier to treat when it has just begun, rather then when it has become a chronic problem. However, when the fascia is properly supported by an orthotic the tears are minimized and healing may begin. When the fascia is pulled away from the bone the body reacts over time by filling in the space with new bone. This causes the classic heel spur. This heel spur is usually a secondary x-ray finding and is not the cause of the problem but rather a result of the problem. What Causes Plantar Fasciitis: Flat over-pronated feet or high arched rigid feet Overuse/training errors too much too soon Standing/walking more than 6 hours a day Inappropriate, improper or worn out shoes Soft terrain (ie running in sand) Inflexibility of the Achilles tendon Increasing age Treatment: Orthotics: They support the arch which controls overstretching of the plantar fascia and reduces tearing. Orthotics also help align your feet to keep your weight centered on your heel instead of on the inside edge. The heel cup in the orthotic redistributes pressure over a larger area, thereby reducing pressure on the centre of the heel. Avoid walking barefoot, even at home. Ideally you would want to wear your custom orthotics as much as possible to keep the stress off the plantar fascia. Muscle/Fascia Therapy: Plantar fascia stripping by having one leg crossed over the other so that you can see the bottom of the affected foot. With one hand pull your toes back to stretch out the plantar fascia. Apply some moisturizing cream to the bottom of your foot. Use the knuckles of your fingers (the middle joints) and apply firm pressure in a downward motion from the ball of your foot to the heel. It should feel like popping bubble wrap when you do this. Repeat the motion around 40 times and do this several times per day. This procedure is painful if done correctly, but the result will be well worth it. Shoes: It is possible for shoes to cause the problem. You may need different or new shoes. Wear supportive and shock-absorbing footwear at all times. Modified Activity: Use pain as your guide. Avoid prolonged standing, excessive walking on hard or rough surfaces, and other weight bearing activities. Ice: Place ice on your heel for 15 minutes several times a day to reduce the inflammation. You can also roll your foot over a frozen can as shown, or frozen bottle of water. Exercises: Your chiropractor will show you how to strengthen the small muscles of your feet and improve the flexibility of your plantar fascia and Achilles tendon. This will support the arch and put less stress on the weakened inflamed plantar fascia. Soak your feet each night in a warm (not hot) Epsom salts bath. Go back into the weight bearing sports slowly. If you have a lot of pain either during the activity or the following morning, youre doing too much. Plantar fasciitis is a very painful condition that affects a majority of the population. Conservative management of this condition works well if done in combination with orthotics, fascia stripping and ice. Remember that you should treat this condition as soon as possible. Living with pain is not a sensible option, and delaying treatment will likely result in increased, prolonged and recurring pain.About the Author:
