What is Plantar Fasciitis?

Also known as “heel pain syndrome,” plantar fasciitis is the most common cause of heel pain, resulting from a gradual degeneration of the plantar fascia or sudden trauma to the area. Patients may describe the sensation as sharp stab or deep ache in the middle of the heel or along the bottom of the foot that typically occurs during walking or standing.

Pain often occurs early in the morning, when taking your first few steps out of bed, or after other long periods of sitting/lying down/non-activity. As the foot naturally tightens at night, the fascia may gain new tears in the morning, initiating a painful cycle. Appearing in one heel or both, the condition tends to be chronic and can be difficult to heal without a combination of conservative treatments and persistence.

Causes of Plantar Fasciitis

• Improper footwear
• Strenuous activity
• Obesity
• Over-pronation
• High arches or flat feet
• Poor shock absorption in shoes

Plantar fasciitis is commonly seen in middle-aged patients, but the young can be affected as well. We also see it often in those who place a great deal of stress on their feet like runners, athletes and soldiers. Plantar fasciitis affects approximately 2 million people in the Canada annually.

Some doctors have the opinion bone spurs are the cause and surgery is required. Bone spurs are not the cause of plantar fasciitis. Surgery will not eliminate the pain, but may weaken or even rupture the plantar fascia!1

Symptoms2

The symptoms of plantar fasciitis are:

• Pain on the bottom of the heel
• Pain in the arch of the foot
• Pain that is usually worse upon arising
• Pain that increases over a period of months
• Swelling on the bottom of the heel

Treatment

In the Office

• Chiropractic adjustments to restore normal joint mechanics and reduce tension
  Custom-made orthotics to help hold the adjustments and position the foot for healing; use in all shoes for best results
  Rehabilitative exercises
  At Home:
• Ice and massage on the sore area using a FootWheel® or a frozen golf ball
• Running and walking on soft surfaces
• Stretching the plantar fascia and the calf muscle area can help to prevent inflammation.
• Recommended Stretches: Taking a lunge position with the injured foot behind and keeping your heels flat on the floor, lean into a wall and bend the knees. A stretch should be felt in the sole and in the Achilles tendon area. Hold the stretch for 20-30 seconds. Also try this stretch with the back leg straight.3
• Rest
• If pain is prolonged and persistent, a plantar night boot or brace is often helpful

Prevention

Stretching before activity, maintaining a healthy weight and wearing supportive footwear all help with prevention. Custom-made functional orthotics are recommended to keep the foot in proper alignment and reduce stress on the plantar fascia.

Recovery
Recovery can be slow and requires patience, with 90% of patients recovering in 6–9 months. A combination of therapies as described above is often the most effective approach.

Contact us today to see if orthotics may be helpful for you.

Sources:
1University of Utah Health Sciences Radio, “Chronic Foot Pain? It Could Be This Common Condition”
2Canadian College of Foot and Ankle Surgeons®, “Heel Pain (Plantar Fasciitis)”
3University of California Davis, “Plantar Fasciitis”