March Madness is coming underway, basketball fever is beginning to set in, and excitement is in the air! Before you take the court though, make sure that heel pain isn’t going to slow you down! One of the most common conditions that I treat as a podiatrist is something called Plantar Fasciitis. It is by far the number one cause of heel pain.
The plantar fascia is a band of connective tissue along the bottom of the foot. It stretches from the heel to the toes, and its purpose in the body is to support the arch of the foot. The plantar fascia can become strained, inflamed, and swollen. This is what causes the immense pain on the bottom of the foot! Things that contribute to plantar fasciitis include feet that roll in too much (pronation), high arched or flat feet, walking, running or standing for long periods (especially on a hard surfaces such as concrete), obesity and improper shoes. Most people find the most extreme pain to be at its worst when they have been sitting for a long period of time and then walking, or after getting up in the morning and then taking their first few steps. There is actually a word created to describe this exact condition, called "post-static dyskinesia." The theory as to why the pain is the worse at these times is because the fascia tightens up when we sleep and sit for long periods. It has lost the ability to stretch. When we walk small micro tears occur to allow the arch of the foot to flatten out.
This condition is easily diagnosed, because of the specific areas of sharp pain that are usually present. An x-ray will most likely be taken to rule out any trauma or stress fracture or bone tumor of the heel bone (calcaneous). Sometimes on x-ray a heel spur can be seen coming off the bottom of the heel bone. Although the literature says as high as 85% of people with heel pain have a heel bone spur, it is very rare that it is ever surgically removed. This is because of the great deal of research that has been put in to treating this condition conservatively.
Treatment options for plantar fasciitis are focused mainly around rest and stretching! The area is inflamed, so it needs some time to relax! To speed up healing, an anti-inflam
matory pill such as ibuprofen (Motrin) or a steroid injection can help. Calf stretching will help release the pull of the calf muscle, which in turn causes the calf muscles not to pull on the fascia as much. Ice and physical therapy can also help with stretching/strengthening exercises, as well as pain relief. Night splints are very helpful as they keep the fascia stretched throughout the night. Orthotics are very important as they accommodate the deformity of the foot and support the arch, preventing the constant stretching of the fascia when we walk. These are used as a long term treatment to prevent any reoccurrence. If all these measures are unsuccessful, do not worry as other options still exist! These include, but are not limited to, minimally invasive endoscopic surgery, Extracorporeal Shockwave Therapy, which uses sound waves to stimulate healing and injection of blood platelet concentrate into the inflamed fascia. Most patients are encouraged to walk after these procedures. Once you start to notice the heel pain, you should try to see your podiatrist before it gets worse! The earlier you treat it, the quicker you can get back in the game, pain free!
The purpose of this blog is to raise awareness about common conditions associated with the foot and ankle. Any advice given, whether medical or legal, is an opinion. For legal counsel or podiatric care, one should see their local podiatrist or attorney. More information can be found at my website www.michiganfootdoctor.com
The plantar fascia is a band of connective tissue along the bottom of the foot. It stretches from the heel to the toes, and its purpose in the body is to support the arch of the foot. The plantar fascia can become strained, inflamed, and swollen. This is what causes the immense pain on the bottom of the foot! Things that contribute to plantar fasciitis include feet that roll in too much (pronation), high arched or flat feet, walking, running or standing for long periods (especially on a hard surfaces such as concrete), obesity and improper shoes. Most people find the most extreme pain to be at its worst when they have been sitting for a long period of time and then walking, or after getting up in the morning and then taking their first few steps. There is actually a word created to describe this exact condition, called "post-static dyskinesia." The theory as to why the pain is the worse at these times is because the fascia tightens up when we sleep and sit for long periods. It has lost the ability to stretch. When we walk small micro tears occur to allow the arch of the foot to flatten out.
This condition is easily diagnosed, because of the specific areas of sharp pain that are usually present. An x-ray will most likely be taken to rule out any trauma or stress fracture or bone tumor of the heel bone (calcaneous). Sometimes on x-ray a heel spur can be seen coming off the bottom of the heel bone. Although the literature says as high as 85% of people with heel pain have a heel bone spur, it is very rare that it is ever surgically removed. This is because of the great deal of research that has been put in to treating this condition conservatively.
Treatment options for plantar fasciitis are focused mainly around rest and stretching! The area is inflamed, so it needs some time to relax! To speed up healing, an anti-inflam
matory pill such as ibuprofen (Motrin) or a steroid injection can help. Calf stretching will help release the pull of the calf muscle, which in turn causes the calf muscles not to pull on the fascia as much. Ice and physical therapy can also help with stretching/strengthening exercises, as well as pain relief. Night splints are very helpful as they keep the fascia stretched throughout the night. Orthotics are very important as they accommodate the deformity of the foot and support the arch, preventing the constant stretching of the fascia when we walk. These are used as a long term treatment to prevent any reoccurrence. If all these measures are unsuccessful, do not worry as other options still exist! These include, but are not limited to, minimally invasive endoscopic surgery, Extracorporeal Shockwave Therapy, which uses sound waves to stimulate healing and injection of blood platelet concentrate into the inflamed fascia. Most patients are encouraged to walk after these procedures. Once you start to notice the heel pain, you should try to see your podiatrist before it gets worse! The earlier you treat it, the quicker you can get back in the game, pain free!The purpose of this blog is to raise awareness about common conditions associated with the foot and ankle. Any advice given, whether medical or legal, is an opinion. For legal counsel or podiatric care, one should see their local podiatrist or attorney. More information can be found at my website www.michiganfootdoctor.com
