The plantar fascia is a fibrous band of connective tissue that originates in part from the heal which extends along the sole of the foot and inserts into base of the toes. It also serves to support the foot arch.
Plantar fasciitis, also known as jogger’s heel, affects the heel and foot. It is a common and painful disorder and is characterized by inflammation, scarring, and the structural breakdown of the plantar fascia of the foot. Increasing exercise intensity, weight, and age can cause and increase of the cases of the disorder. It is not only an inflammatory process, but also a degenerative one.
At some point during their lifetime, about 10% of individuals will develop and suffer from plantar fascia. The disorder is typically associated with long period of standing. Those with flat feet are also more prone to developing plantar fascia. Further, obesity and a sedentary lifestyle are also major contributing factors.
The heel pain felt is usually associated with pain on the bottom of the heel. The first steps of the day elicits the greatest pain intensity. Those who suffer from plantar fascia also suffer from difficulty with dorsiflexion of the foot, in which the foot is brought towards the shin. This is due to the calf muscle being stiff, or with the Achilles tendon, which is connected to the plantar fascia, also being stiff.
Most cases resolve themselves over time. Some do require more formalized treatment plans, however. When the pain of plantar fascia first develops, the pain is usually very sharp and unilateral. The pain worsens in the heel when weight is borne on it, especially after prolonged periods of rest, like during sleep. With continued walking, the symptoms improve. In some cases, numbness and tingling is also present, as is pain that radiates through the leg.
Some risk factors associated with the disorder include excessive running, standing for prolonged periods of time, especially on hard surfaces, high foot arches, and flat feet. Flat feet are a risk factor because the foot shape tends to have a tendency to roll in when the individual is walking, which makes the foot susceptible to developing plantar fascia.
The disorder is typically diagnosed by a health specialist. The examiner may look for tenderness of the heel and sole of the foot. The foot may be unable to engage in dorsiflexion when the examiner asks a patient to do so. If dorsiflexion is possible, it may be painful to the patient. Diagnostic imaging is not typically used to verify the diagnosis of plantar fascia. However, some cases warrant X-rays or MRIs for diagnosis.
Treatment of plantar fascia cases focus on the following:
Relieving inflammation and pain in the heel
Allowing tears in the ligament to heal
Improving the strength and mobility of the foot
Treatment includes resting the foot. Limiting or stopping activities that cause heel pain are recommended. Avoid running and walking, especially on hard surfaces. Ice can be used to reduce the inflammation associated with plantar fascia. Pain-relievers may also be recommended. Shoe inserts may be helpful in supporting the arch of the foot. A weight management plan may also be a component to promote sustainable improvement in the symptoms. Toe and calf exercises, especially stretches, may be beneficial in relieving the symptoms of plantar fascia. Acupuncture offered at our clinic can also promote healing, and regular chiropractic treatments may also be recommended.