Plantar Fasciitis – What To Expect?

Plantar Fasciitis - runner
What is Plantar Fasciitis

The plantar fascia is a tough, fibrous band of tissue that attaches from your calcaneus (heel) to the base of your toes. When working correctly, it supports the foot’s arch and absorbs shock when walking. However, repeated stress, tension and micro-tearing of the facia through repetitive strain can result in degeneration of the soft tissue and develop into plantar fasciitis. 

Plantar fasciitis is one of the most common conditions causing heel pain. Although having a large biomechanical element, the exact cause behind the condition is poorly understood. It is thought that the constant stress and tension applied to the plantar fascia through standing and walking causes it to lose its elastic properties with routine daily activities.

planta Fasciitis - ball
What factors contribute to Plantar Fasciitis?

Some of the contributing factors causing degeneration and pain within the plantar fascia include: 

    • Increase in activity levels.
    • Sudden changes in footwear.
    • The surface on which you are standing, walking or running.
    • Genetic factors such as the structure or shape of the foot.
    • Comorbidities such as rheumatoid arthritis and lupus.
What factors contribute to Plantar Fasciitis?

Some of the contributing factors causing degeneration and pain within the plantar fascia include: 

    • Increase in activity levels.
    • Sudden changes in footwear.
    • The surface on which you are standing, walking or running.
    • Genetic factors such as the structure or shape of the foot.
    • Comorbidities such as rheumatoid arthritis and lupus.
What Are The Symptoms Of Plantar Fasciitis?

Foot pain, specifically within the heel, is usually the first symptom of plantar fasciitis. The onset of pain usually is gradual but can be sudden in specific movement patterns such as jumping or high-impact sports. The foot pain tends to be the worst when you get up in the morning or after other periods of inactivity, hence why it’s colloquially called ‘first-step pain’. The degree of discomfort can sometimes lessen with activity during or after warming up, but it can worsen after prolonged or vigorous exercise. The pain may also appear more intense on bare feet or in shoes with minimal support.

heel Spur
How Is Plantar Fasciitis Diagnosed?

For accurate  diagnosis of plantar fasciitis, separating the heel pain/foot pain from other common conditions is needed. Some other conditions that share similar symptoms of plantar fasciitis include:

    • Nerve compression in the foot or the back.
    • Stress fracture of the calcaneus.
    • Loss of the fatty tissue pad under the heel.
    • Heel Spurs. 
    • Inflammatory arthritis. 

Plantar fasciitis can be distinguished from these and other conditions based on medical history and examination by your primary healthcare provider. Heel spurs are often wrongly thought to be the sole cause of heel pain. Although common, they are nothing more than the bone’s response to traction or pulling forces from the plantar fascia and other foot muscles. Heel spurs often don’t cause any pain.

How Is Plantar Fasciitis Diagnosed?

For accurate  diagnosis of plantar fasciitis, separating the heel pain/foot pain from other common conditions is needed. Some other conditions that share similar symptoms of plantar fasciitis include:

    • Nerve compression in the foot or the back.
    • Stress fracture of the calcaneus.
    • Loss of the fatty tissue pad under the heel.
    • Heel Spurs. 
    • Inflammatory arthritis. 

Plantar fasciitis can be distinguished from these and other conditions based on medical history and examination by your primary healthcare provider. Heel spurs are often wrongly thought to be the sole cause of heel pain. Although common, they are nothing more than the bone’s response to traction or pulling forces from the plantar fascia and other foot muscles. Heel spurs often don’t cause any pain.

How is Plantar Fasciitis Treated?

Plantar fasciitis treatment usually depends on the time the symptoms have been present and the severity of the pain. It can take 6-12 months for your foot to return to normal. Other cases can become chronic and unremitting until effective treatment is sought.  Additionally, high-demand athletes, such as cross-country or marathon runners, may require a longer course of treatment. Some of the standard treatment therapies for plantar fasciitis include:

    • Stretching and Physical Therapy: Focusing on the plantar fascia and the Achilles tendon. A physical therapist can show you stretching exercises you can repeat at home several times daily. Along with stretching, the exercises can also strengthen your lower leg muscles, helping stabilise your ankle.
    •  
    • Icing and Medication: This can help manage heel/foot pain. Nonsteroidal anti-inflammatory medications can be used for managing pain.
    •  
    • Rest and Orthotics: Keeping weight off the foot allows quicker healing. Switching shoes with arch support or other orthotics to cushion the heel can reduce stress within the plantar fascia. 
    •  
    • Shockwave Therapy: Extracorporeal shockwave therapy creates microscopic trauma, which triggers a healing response from the body. This process is thought to help promote healing in the plantar fascia.
    •  
    • Cortisone Injections: In situations where there is no improvement in your foot/heel pain, C=cortisone injections may be required. 
    •  
    • Surgery: In most situations, surgery isn’t required but is available in severe cases. The surgery for plantar fasciitis is called gastrocnemius recession or gastrocnemius release.

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