Plantar fasciitis is a common cause of pain in the heel. It is due to irritation and inflammation of the plantar fascia (a long thin band that connects the heel to the front of toes and supports the arch of the foot).
The plantar fascia is designed to absorb the stress and strains placed on the feet. The fascia may be inflamed as a result of overuse which results in heel pain and stiffness of the plantar fascia.
Risk factors for Heel Plantar Fasciitis include:
- Faulty foot biomechanics, which places excessive stress on the heel bone, ligaments, and nerves near the heel.
- Running or jogging, especially on hard surfaces.
- Poorly fitted or badly worn shoes, especially those lacking appropriate arch support
Other risk factors associated with Plantar Fasciitis include:
- Plantar fascia flexibility decreases with age making it prone to wear and tear.
- Malnutrition, causing absorption of fat from cushioning fat tissue of the heel.
- Standing and walking work demands on a daily basis.
- A sudden increase in activity in a lesser active population.
- Flat feet
Heel spurs are present in most cases of plantar fasciitis cases but often not the source of pain. Heel spurs are developed as a result of stress produced at the site of attachment of the fascia to the calcaneum. This results in the formation of new bone at this site.
Symptoms of Plantar Fasciitis
The most common symptoms of plantar fasciitis include:
- Pain on the bottom of the foot near the heel and on the inner side of the heel.
- Heel pain is the first worse thing in the morning, or after a period of rest. The pain subsides after a few minutes of walk.
Treatment of Plantar Fasciitis
The initial treatment aims at reducing pain.
- This can be achieved through the icing. Apply ice 10-15 mins every 3-4 hours alternatively Ice rolling can be done for 15-20 mins trice daily. A contrast bath can be used if persistent swelling is seen.
- Physiotherapeutic modalities such as ultrasound, LASER, and shock therapy can be used to treat the condition.
- Stretching exercises include plantar fascia and calf stretches.
- If a hindfoot varus deformity is observed, arch support can be prescribed to the patient.
- Strengthening exercises of ankle muscles particularly those needed in supporting the arch of the foot. Gripping exercises with toes to strengthen the intrinsic foot muscles.
- Thrust manipulation can be used to correct a fixed calcaneum in varus/ valgus position.
- Myofascial release techniques are used to release adhesions in soft tissues and to promote proper excursion of tendons smoothly along the fascial planes.
- Heel cushions can be used as shoe inserts to reduce the pressure on the inflamed tissue.
- Nonsteroidal anti-inflammatory drugs can be prescribed by an Orthopaedician. Corticosteroid injections can be given to resistant cases of plantar fasciitis.