What Is Plantar Fasciitis?

Heel Pain caused by Plantar Fasciitis is an inflammation of the plantar fascia at its insertion onto the calcaneus, or heel bone. The root cause behind heel pain is equinus, or a tight Achilles’ tendon.  With a tight Achilles’ tendon, there is limited ankle joint motion. With limited ankle joint motion, the foot has to work harder, or over-pornate, to produce normal gait. Over pronation, over time, creates an abnormal pull on the plantar fascia, which can become irritated and become very painful.

Some things that aggravate or make plantar fasciitis worse are: bare feet, flip flops and flats. Usually a shoe with a slight heel will relieve the pain.

What are the Symptoms of Plantar Fasciitis?

1. Pain at the bottom of the heel
2. Pain that is the most intense with the first steps in the morning, or after periods of rest
3. Typically, the pain is better after a few minute of walking around

How is Plantar Fasciitis Treated?

For Acute Plantar Fasciitis, the Triad of Treatment is Stretching, Treating the Inflammation, and Splinting the Fascia.

A.  Stretching the Achilles’ Tendon

The key to stretching exercises is lengthening the Achilles’ tendon. This allows more motion at the ankle joint, thus relying less on the plantar fascia for normal gait. Equinus, or a tight Achilles’ tendon, is the root cause behind plantar fasciitis.

B.  Treating the Inflammation

Inflammation of the plantar fascia is what causes pain. Treating the inflammation can be done with steroid injections, oral steroids, oral NSAIDs, and ice massage.

Note:  Please consult a physician before taking any medications.

C.  Splinting the Fascia

This is done to help prevent the fascia from flattening out with each step. Each time the fascia flattens out; it pulls off the heel bone, and recreates the pain.

For Chronic Plantar Fasciitis or plantar fasciitis that has occurred longer than 6 months is treated slightly differently:

A.  ESWT: Extracorporeal Shockwave Therapy

ESWT is an FDA approved form of treatment. It is a non-surgical approach to pain relief that is used regularly to cure common problems like Chronic Plantar Fasciitis and Chronic Achilles Tendonitis.

The therapy works by targeting shockwaves directly to the area that is experiencing pain. This is a non-invasive procedure that includes 3 weekly sessions that typically last less than 30 minutes per session. Watch a video!

B.  Plantar Fascial Release

If the above mentioned conservative therapy fails, a surgical release of the plantar fascia may also be performed. An incision is made on the bottom of the foot and the contracted, scarred fascia is released. This can also be performed using an endoscope.

If you have plantar fasciitis, contact one of the Foot and Ankle Specialists at Academy Foot and Ankle to see which treatment, or combination of treatments is right for you.