posted on 11 Mar 2014 06:37 by ultimateheightreview
The main symptom of plantar fasciitis is the feeling of acute pain in the inner side of the heel. If an intense pain is felt in the heel on taking the first few steps in the morning, then it is most likely a case of plantar fasciitis The pain eases as the day progresses because the plantar fascia gradually stretches due to warming up of the feet. Sometimes, the pain may start as a dull pain in the heel and the arch and may later accentuate to a sharp, persisting pain. Patients suffering from plantar fasciitis may also find climbing stairs or walking on the toes very painful.
If your foot flattens or becomes unstable during critical times in the walking or running cycle, the attachment of the plantar fascia into your heel bone may begin to stretch and pull away from the heel bone. This will result in pain and possibly swelling. The pain is especially noticeable when you push off with your toes while walking. Since this movement stretches the already injured portion of the fascia. Without treatment the pain will usually spread around the heel. The pain is usually centeredat a location just in front of the heel toward the arch. This results in the development of a heel spur.
The repetitive stress of certain conditions or activities commonly leads to plantar fasciitis. Repetitive pressure on the feet from jobs or activities that require prolonged walking or standing on hard on irregular surfaces - or running and exercise - can also lead to wear and tear on the plantar fascia. Aggravating factors, such as being overweight or having poorly cushioned shoes can also add to the cause of plantar fasciitis. The natural aging process (whoopee for me) may also cause tissue in the heels to weaken over time and/or promote wear and tear.
Inappropriate footwear is the No. 1 cause of plantar fasciosis. Footwear that possesses toe spring and a tapered toe box holds your big toe in an adducted and extended position. In this position, your abductor hallucis muscle—the muscle responsible for moving your big toe away from your foot’s midline—pulls on a foot structure called the flexor retinaculum and may restrict blood flow through your posterior tibial artery, the vessel that carries blood to the bottom of your foot. Tissues in the sole of your feet begin to degenerate as blood supply to this area is decreased.
Surgery carries the risk of nerve injury, infection, rupture of the plantar fascia, and failure of the pain to improve. 13 Surgical procedures, such as plantar fascia release, are a last resort, and often lead to further complications such as a lowering of the arch and pain in the supero-lateral side of the foot due to compression of the cuboid bone 14 An ultrasound guided needle fasciotomy can be used as a minimally invasive surgical intervention for plantar fasciitis. A needle is inserted into the plantar fascia and moved back and forwards to disrupt the fibrous tissue. 15
X-rays of the heel can oftentimes show calcifications within the Achilles tendon at its insertion site or calcifications on the bottom of the calcaneus near the insertion of the plantar fascia. The first exercise involves facing a wall and having your feet flat on the floor with your toes approximately 12 to 15 inches from the wall. At this point, keeping your heel flat against the floor, one must lean into the wall and touch their chest against the wall and hold the stretch for approximately one minute. The ideal angle for the bottom of the foot should be 45 degrees.
Make an appointment with a podiatrist, a doctor who specializes in foot problems. While you are waiting to see your podiatrist, avoid standing and walking for long periods and do not run or engage in sports or carry heavy objects. Prepare an ice pack by placing crushed ice inside a plastic bag and wrapping a towel around the bag. Rest your feet on the ice pack for 15 to 20 minutes once or twice each day. Take nonsteroidal anti-inflammatory drugs daily. Wear running shoes with inside padding and good heel support instead of your regular shoes. Noninvasive Treatments
Plantar fasciitis is a common cause of heel pain in adults. The pain is usually caused by collagen degeneration (which is sometimes misnamed “chronic inflammation”) at the origin of the plantar fascia at the medial tubercle of the calcaneus. This degeneration is similar to the chronic necrosis of tendonosis, which features loss of collagen continuity, increases in ground substance (matrix of connective tissue) and vascularity, and the presence of fibro-blasts rather than the inflammatory cells usually seen with the acute inflammation of tendonitis. 1 The cause of the degeneration is repetitive microtears of the plantar fascia that overcome the body's ability to repair itself.
Someone will cause wear and tear on their plantar fascia at the insertion on the heal bone, and at night this strain is relieved when they lie horizontally and allow their feet to go limp. From this orientation, their foot and leg are in a position totally different from the one found through much of the day. This relaxed position causes the plantar fascia to become similar to a relaxed rubber band. With all of the healing that occurs during sleep being destroyed every morning, the restorative nature of sleep is no longer found in the heel, and the pain continues.
For immediate pain relief, your podiatric physician can give you a cortisone injection. There are many conservative treatments for plantar fasciitis that when used accordingly are very successful. You should be icing and stretching the bottom of your foot daily. Your podiatric physician may refer you to a physical therapist to aid in your treatment and to teach you the most effective stretching techniques for your foot type and condition. You may also be advised to wear a night splint that stretches your tendons and fascia in your foot while you sleep. These treatments can significantly reduce the inflammation of your plantar fascia and thus reduce your pain.