Plantar fasciitis is a common foot disorder that affects more than two million people every year, especially runners. It is inflammation of the plantar fascia, a thick band of tissue on the bottom of
the foot. The most common area of pain is directly on the bottom of the heel, although some people may only have pain in the arch of the foot. Diagnosis of plantar fasciitis is typically done through
a physical examination, which includes listening to the patient history, palpation of the heel and possibly x-rays.
The plantar fascia can also become aggravated by repetitive activity. If you increase the number of times the heel hits the ground, that can cause plantar fasciitis, a number of people develop
problems when their feet are unaccustomed to hard tile or wood floors. Other risk factors for plantar fasciitis include obesity, an extra high or low foot arch, and activities like running.
The condition typically starts gradually with mild pain at the heel bone often referred to as a stone bruise. You're more likely to feel it after (not during) exercise. The pain classically occurs
right after getting up in the morning and after a period of sitting. If you don't treat plantar fasciitis, it may become a chronic condition. You may not be able to keep up your level of activity,
and you may develop symptoms of foot, knee, hip and back problems because plantar fasciitis can change the way you walk.
During the physical exam, your doctor checks for points of tenderness in your foot. The location of your pain can help determine its cause. Usually no tests are necessary. The diagnosis is made based
on the history and physical examination. Occasionally your doctor may suggest an X-ray or magnetic resonance imaging (MRI) to make sure your pain isn't being caused by another problem, such as a
stress fracture or a pinched nerve. Sometimes an X-ray shows a spur of bone projecting forward from the heel bone. In the past, these bone spurs were often blamed for heel pain and removed
surgically. But many people who have bone spurs on their heels have no heel pain.
Non Surgical Treatment
Plantar fasciitis treatment can be conservative (non-surgical) or invasive (surgical). Among the non-surgical ways to manage plantar fasciitis involves stretching and icing exercises. A night splint
which help stretch the Achilles tendon and plantar fascia overnight, so that they can be more easily stretched during the morning. Orthotics that can be custom-made for the feet can also distribute
tension on the feet more consistently. Corticosteroid is injected into the affected area to relieve pain and decrease inflammation. Doctors may also use extracorporeal shockwave therapy before
considering plantar fasciitis surgery. During the therapy, sound waves are used to stimulate the affected area and eventually heal it. Physical therapy incorporation, deep massage stretching, and
other modalities can at times be a helpful adjunct treatment. Surgery for plantar fasciitis is only considered when all other conservative treatments have failed.
Surgery for plantar fasciitis can be very successful in the right patients. While there are potential complications, about 70-80% of patients will find relief after plantar fascia release surgery.
This may not be perfect, but if plantar fasciitis has been slowing you down for a year or more, it may well be worth these potential risks of surgery. New surgical techniques allow surgery to release
the plantar fascia to be performed through small incisions using a tiny camera to locate and cut the plantar fascia. This procedure is called an endoscopic plantar fascia release. Some surgeons are
concerned that the endoscopic plantar fascia release procedure increases the risk of damage to the small nerves of the foot. While there is no definitive answer that this endoscopic plantar fascia
release is better or worse than a traditional plantar fascia release, most surgeons still prefer the traditional approach.
You may begin exercising the muscles of your foot right away by gently stretching them as follows. Prone hip extension, Lie on your stomach with your legs straight out behind you. Tighten up your
buttocks muscles and lift one leg off the floor about 8 inches. Keep your knee straight. Hold for 5 seconds. Then lower your leg and relax. Do 3 sets of 10. Towel stretch, Sit on a hard surface with
one leg stretched out in front of you. Loop a towel around your toes and the ball of your foot and pull the towel toward your body keeping your knee straight. Hold this position for 15 to 30 seconds
then relax. Repeat 3 times. When the towel stretch becomes too easy, you may begin doing the standing calf stretch. Standing calf stretch, Facing a wall, put your hands against the wall at about eye
level. Keep one leg back with the heel on the floor, and the other leg forward. Turn your back foot slightly inward (as if you were pigeon-toed) as you slowly lean into the wall until you feel a
stretch in the back of your calf. Hold for 15 to 30 seconds. Repeat 3 times. Do this exercise several times each day. Sitting plantar fascia stretch, Sit in a chair and cross one foot over your other
knee. Grab the base of your toes and pull them back toward your leg until you feel a comfortable stretch. Hold 15 seconds and repeat 3 times. When you can stand comfortably on your injured foot, you
can begin standing to stretch the bottom of your foot using the plantar fascia stretch. Achilles stretch, Stand with the ball of one foot on a stair. Reach for the bottom step with your heel until
you feel a stretch in the arch of your foot. Hold this position for 15 to 30 seconds and then relax. Repeat 3 times. After you have stretched the bottom muscles of your foot, you can begin
strengthening the top muscles of your foot. Frozen can roll, Roll your bare injured foot back and forth from your heel to your mid-arch over a frozen juice can. Repeat for 3 to 5 minutes. This
exercise is particularly helpful if done first thing in the morning. Towel pickup, With your heel on the ground, pick up a towel with your toes. Release. Repeat 10 to 20 times. When this gets easy,
add more resistance by placing a book or small weight on the towel. Balance and reach exercises, Stand upright next to a chair. This will provide you with balance if needed. Stand on the foot
farthest from the chair. Try to raise the arch of your foot while keeping your toes on the floor. Keep your foot in this position and reach forward in front of you with your hand farthest away from
the chair, allowing your knee to bend. Repeat this 10 times while maintaining the arch height. This exercise can be made more difficult by reaching farther in front of you. Do 2 sets. Stand in the
same position as above. While maintaining your arch height, reach the hand farthest away from the chair across your body toward the chair. The farther you reach, the more challenging the exercise. Do
2 sets of 10. Heel raise, Balance yourself while standing behind a chair or counter. Using the chair to help you, raise your body up onto your toes and hold for 5 seconds. Then slowly lower yourself
down without holding onto the chair. Hold onto the chair or counter if you need to. When this exercise becomes less painful, try lowering on one leg only. Repeat 10 times. Do 3 sets of 10. Side-lying
leg lift, Lying on your side, tighten the front thigh muscles on your top leg and lift that leg 8 to 10 inches away from the other leg. Keep the leg straight. Do 3 sets of 10.