Plantar Fasciitis is inflammation of the plantar fascia. The plantar fascia is a thick band of tissue that originates at the heel bone, extends forward under the arch and inserts itself to the tissue under the balls of the feet. The purpose of the plantar fascia is to maintain the arch shape in one’s foot by binding the bones, muscles, ligaments and soft tissues together.
When the arch flattens, the plantar fascia may stretch excessively, resulting in micro-tears where it attaches at the heel. Inflammation usually occurs at this point. The painful micro-tears subside during rest periods, but upon standing, the fascia re-tears resulting in a
burst of exquisite pain.
SYMPTOMS
The most common symptoms associated with plantar fasciitis include:
- Pain where the heel and arch meet, with pain across the underside of the foot (predominantly on the inside of the foot (medial side).
- Exquisite pain with the first step after a night’s sleep or a prolonged rest period.
CAUSES
The most common causes of plantar fasciitis include:
- Overuse from walking and standing for long hours.
- Hyperpronation and hypersupination.
- Forefoot mal-alignment.
- Weight gain, physical condition, overall muscular conditioning and body weight relative to height.
- Pregnancy.
- Unsupportive footwear.
TREATMENT
Foot Stretching and Icing
In mild cases, research has shown that very simple foot stretching techniques can often provide initial relief from this most common type of heel pain. Icing is also strongly recommended to reduce inflammation.
Orthotics (Orthoses) – Must be prescribed by a physician
Custom made orthotics support the skeleton, muscles and fascia in the correct position. Orthotics are a long-term solution to prevent reoccurrence by controlling and / or correcting the mechanics that cause the problem. Orthotics for plantar fasciitis should include:
- A cupped heel to distribute pressure evenly and away from the painful heel center.
- Arch support to stabilize and relieve muscles and soft tissue.
- Heel raise to lessen tension from gastrocnemius muscle tightening.
- Forefoot postings, often under medial 1st metatarsal phalangeal joint, to correct forefoot alignment (as necessary).
Footwear
Stability footwear including therapeutic and orthopaedic shoes are integral to the treatment process. Certified Pedorthists are trained to fit patients with appropriate footwear. BioPed offers many types of footwear into which an orthotic device may be placed or worn alone. We also suggest leaving supportive sandals or footwear beside the bed at night. Immediately upon rising, put them on.
Footwear for plantar fasciitis should have the following characteristics:
- Rocker forefoot sole which allows gait without bending through the metatarsal joints and decreases fascia elongation at toe-off.
Modifications to footwear are also available at the discretion of the Pedorthist.
