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Plantar Fasciitis (FASH-ee-EYEtiss) is commonly known as "heel spur syndrome". It is common among people who are active in sports (i.e. running). This pain generally begins as a dull pain in the heel that may come and go. At times the pain may be sharp and persistent. The pain is usually worse after times of rest such as sitting or sleeping; therefore, more pain is noticed in the mornings or at the start of physical activities. The plantar fascia is a thick fibrous band on the bottom of the foot. This is attached from the heel bone to the toes and acts as a bowstring to produce the arch of the foot.
Running and other activities may place tension on the fascia. This prolonged tension causes the fascia to swell at the point where the fascia is attached to the heel bone. Injury may also occur at the mid-sole or near the toes. It is difficult to rest the foot; therefore, it is important to seek treatment as soon as possible so that the problem does not progress.
The swelling reaction of the heel bone may produce new bone called heel spurs. They are not initially painful and do not cause the problem; however, walking on spurs may cause sharp pain. Some contributing factors include flat feet, high arched feet, poor shoe support, toe running, soft terrain, increasing age, sudden increase in activity level, or family tendency.
Keep in mind that plantar fasciitis may be aggravated by weight bearing sports.
Improvement may take longer if the condition has existed for a long time. It is important to wear good shoes and to lose excess weight. During the recovery period, it would be helpful to replace weightbearing sports with non-weight bearing sports such as cycling or swimming. Weight training will help to maintain leg strength. A sport is considered weight-bearing if the foot is repeatedly landing on the ground such as running or jogging.
Treatment of plantar fasciitis includes rest. Pain will be the guide to let you know when you should rest your foot. Ice can be applied for 30 to 60 minutes several times a day to reduce swelling. The ice can be placed in a plastic bag covered with a towel. Apply ice for approximately 15 minutes after activity. Anti-inflammatory/analgesic medication may also be used to reduce swelling.
If there is no help after 2-3 weeks, the physician may decide to inject the tender area with cortisone or a local anesthetic. A heel or felt sponge can help to spread, equalize, and absorb the shock as your heel lands. This would ease the pressure on the plantar fascia. You may need to cut a hole in the sponge over the painful area to avoid in-itation. Surgery is rarely required for plantar fasciitis. It would only be considered if all other forms of conservative treatment fails. When necessary, surgery requires the removal of the bone spur and release of the plantar fascia. After recovery, return to sports activities slowly. Pain will indicate that you are doing too much. Your physician can give you the proper exercises to strengthen the small muscles of the foot and to support the damaged areas. This will help prevent re-injury.
Article summarized from Krames Orthopedic Sports Medicine Kit.
Article by Shaheer Yousaf, M.D., FACS