Plantar Fasciitis is a common athletic injury of the foot. While runners are most likely to suffer from plantar fasciitis, any athlete whose sport involves intensive use of the feet may be vulnerable. The risk of plantar fasciitis increases in athletes who have a particularly high arch, or uneven leg length, though improper biomechanics of the athlete’s gait and simple overuse tend to be the primary culprits. If you suffer from plantar fasciitis or are seeking to prevent its occurrence it is important to follow the information in this article. In addition, adding a few simple stretches to your fitness program will also help.
Far and away the most common cause of plantar fasciitis in an athlete is faulty biomechanics of the foot or leg. Faulty biomechanics causes the foot to sustain increased or prolonged stresses over and above those of routine ground contacts. Throughout the phase of ground contact, the foot assumes several mechanical positions to dissipate shock while at the same time placing the foot in the best position to deliver ground forces. With heel landing the foot is supinated (ankle rolled out). At mid-stance the foot is pronated (ankle rolled in). The foot is supinated again with toe-off. The supination of the foot at heel strike and toe-off makes the foot a rigid lever. At heel strike the shock of ground contact is transferred to the powerful quads. During toe-off forward motion is created by contraction of the gastroc complex plantar flexing the rigid lever of the foot pushing the body forward.
If you are concerned that you may have developed this syndrome, review this list of symptoms to see if they match with your experience. Aching, sharp or burning pain in the sole of your foot, often centering in the heel area. Foot pain that occurs as soon as you step out of bed or get to your feet after prolonged periods of sitting. Pain that may decrease eventually after you’ve been on your feet for awhile, only to return later in the day. Sudden heel pain or pain that builds gradually. Foot pain that has lasted for more than a few days, or which you experience periodically over the course of months or years. Pain in just one foot, though it is possible to have Plantar Fasciitis affect both feet. Swelling, redness, or feelings of heat in the heel area. Limping.
After you describe your symptoms and discuss your concerns, your doctor will examine your foot. Your doctor will look for these signs. A high arch, an area of maximum tenderness on the bottom of your foot, just in front of your heel bone. Pain that gets worse when you flex your foot and the doctor pushes on the plantar fascia. The pain improves when you point your toes down. Limited “up” motion of your ankle. Your doctor may order imaging tests to help make sure your heel pain is caused by plantar fasciitis and not another problem. X-rays provide clear images of bones. They are useful in ruling out other causes of heel pain, such as fractures or arthritis. Heel spurs can be seen on an x-ray. Other imaging tests, such as magnetic resonance imaging (MRI) and ultrasound, are not routinely used to diagnose plantar fasciitis. They are rarely ordered. An MRI scan may be used if the heel pain is not relieved by initial treatment methods.
Non Surgical Treatment
Plantar fasciitis is usually controlled with conservative treatment. Following control of the pain and inflammation an orthotic (a custom made shoe insert) will be used to stabilize your foot and prevent a recurrence. Over 98% of the time heel spurs and plantar fasciitis can be controlled by this treatment and surgery can be avoided. The orthotic prevents excess pronation and prevents lengthening of the plantar fascia and continued tearing of the fascia. Usually a slight heel lift and a firm shank in the shoe will also help to reduce the severity of this problem. The office visit will be used for careful examination and review to distinguish plantar fasciitis and plantar heel pain syndrome from other problems, many of which are outlined below. It is important to distinguish between a stress reaction of the calcaneus and plantar fasciitis. A feature of many calcaneal stress fractures is pain on lateral and medial compression of the calcaneus.
Surgery is not a common treatment for this condition. Approximately 5% of people with plantar fasciitis require surgery if non-surgical methods do not help to relieve pain within a year. The surgical procedure involves making an incision in the plantar fascia in order to decrease the tension of the ligament. Potential risks of this surgical procedure include irritation of the nerves around the heel, continued plantar fasciitis, heel or foot pain, infection, flattening of the arch, problems relating to the anesthetic.
In one exercise, you lean forward against a wall with one knee straight and heel on the ground. Your other knee is bent. Your heel cord and foot arch stretch as you lean. Hold for 10 seconds, relax and straighten up. Repeat 20 times for each sore heel. It is important to keep the knee fully extended on the side being stretched. In another exercise, you lean forward onto a countertop, spreading your feet apart with one foot in front of the other. Flex your knees and squat down, keeping your heels on the ground as long as possible. Your heel cords and foot arches will stretch as the heels come up in the stretch. Hold for 10 seconds, relax and straighten up. Repeat 20 times. About 90 percent of people with plantar fasciitis improve significantly after two months of initial treatment. You may be advised to use shoes with shock-absorbing soles or fitted with an off-the-shelf shoe insert device like a rubber heel pad. Your foot may be taped into a specific position. If your plantar fasciitis continues after a few months of conservative treatment, your doctor may inject your heel with steroidal anti-inflammatory medication. If you still have symptoms, you may need to wear a walking cast for two to three weeks or a positional splint when you sleep. In a few cases, surgery is needed for chronically contracted tissue.