The plantar fascia is a long, thin ligament present at the bottom of the foot that creates the arch of the foot. It extends from the heel bone then splits and fans intent to attach itself to the toes.
Plantar fasciitis is a condition where the plantar fascia involves inflammation of a thick band of tissue that runs across the bottom of your foot and connects your heel bone to your toes.
Plantar Fasciitis Causes
Plantar fasciitis happens after you strain or irritate the plantar fascia ligament. The repeated strain will cause little tears within the ligament, leading to pain and swelling. Plantar fasciitis from overstretching or overuse, causing pain in the heel and bottom of the foot. It can occur in one or both feet because of excessive standing and is one of the most common orthopedic complaints, especially in active men between 40 and 70 years of age.
Strains can occur because of:
- High or low foot arch
- Obesity or sudden weight gain
- Tight Achilles tendon that connects the calf muscles to the heel
- Starting a new activity or increasing the intensity of an activity
- Wearing improper shoes that are too soft or hard, do not fit well or offer poor arch support
Plantar Fasciitis Symptoms
The major trouble of plantar fasciitis is pain and stiffness in the heel and foot. The foot pain associated with this condition becomes more intense:
- In the morning after you go out of bed
- Walking after sitting or standing for some time
- After exercise
- Climbing stairs
Plantar Fasciitis Diagnosis
Your physicians diagnose plantar fasciitis after reviewing your medical history and physical examination of the foot to check for tenderness, stiffness, or redness of the sole. Your physicians may watch how you stand and walk and evaluate related conditions such as high arches.
They can take x-rays of the foot if your physicians suspect a stress fracture, a hairline fracture in the bone, or other related conditions such as a heel spur, which is extra calcium deposit on the heel bone.
Plantar Fasciitis Treatment
Treatment involves conservative measures to resolve the condition-
- Rest: The first step is rest, which is considered to reduce pain and prevent further damage to the ligament.
- Ice: Ice can be very effective in reducing swelling and is recommended for 20 minutes, 3-4 times a day.
- Medications: They may prescribe NSAIDs (non-steroidal anti-inflammatory drugs) for relief of pain and inflammation.
- Exercise: Calf stretching exercises and stretches of the plantar fascia are effective in relieving pain.
They may administer a steroid injection into the plantar fascia for reducing pain and inflammation.
It may also recommend supportive shoes and orthotics to reduce pain while walking or standing.
Your physicians can suggest night splints to help stretch the plantar fascia while sleeping.
Physical therapy is also counseled for instruction on stretching exercises, massage, and ice treatments.
The physical therapist may use extracorporeal shock-wave therapy (ESWT), which uses high-energy Shockwave impulses to stimulate healing of the damaged plantar fascia tissues.
Plantar Fasciitis Surgery
It considers only plantar fasciitis surgery if conservative therapy does not provide effective relief after 12 months. There are two surgeries options that will depend on your particular situation.
- Gastrocnemius Recession – Gastrocnemius muscles can strain the plantar fascia. To release this stress, your surgeon can surgically lengthen the calf muscle and increase the motion of the ankle joint. The surgery can be performed by open incision or endoscopically through a small incision by using an endoscope.
- Plantar Fascia Release- If you have the normal range of ankle motion, they recommend a partial release procedure. Your surgeon will partially cut the plantar fascia ligament to relieve the tension. The surgery can be performed endoscopically but open incision is easier to perform and is associated with a lower risk of nerve damage.
Risks and Complications
Complications are rare following surgery to treat plantar fasciitis; Some complications may include:
- Nerve damage
- Unresolved Pain