Plantar Fasciitis

I have been having heel pain, especially in the morning. What can it be?

Plantar Fasciitis is a common foot disorder that can affect both recreational activities and daily tasks. The classic complaint with plantar fasciitis is heel pain when taking the first few steps after getting out of bed. Pain is usually in the front and bottom of the heel but can be over any portion of the bottom of the foot where the fascia is located. Plantar fasciitis is an inflammation of the plantar fascia, which is a connective tissue that encapsulates muscles in the bottom of the foot and supports the arch. When walking, at the moment the heel rises, the plantar fascia endures tension that is approximately two times your body weight. If there is decreased flexibility of the calf muscles, this moment of maximal tension is increased and over-stress can occur. Plantar fasciitis is associated with “heel spur syndrome” but one can have plantar fasciitis without actually having a bony spur. Additionally, one can have a bony spur without symptoms of plantar fasciitis.

Lack of flexibility in the calf muscles, being overweight, and over-activity can be contributing factors to the occurrence of plantar fasciitis. Pain associated with plantar fasciitis usually comes on gradually over weeks to months before help is sought and improvement of the condition can be just as slow. The condition is usually treated conservatively with a variety of methods. These include rest, ice after activity, stretching the calf muscles (especially first thing in the morning), arch supports, and weight loss. If seeking medical intervention, a physician may recommend anti-inflammatory medications and/or physical therapy. During physical therapy, your treatment will likely include cross friction massage of the plantarfascia in conjunction with ultrasound and ice massage. Your therapist may also try taping or recommend shoe insoles or a new type of shoe. Surgery is a last resort and can be prevented by seeking medical attention as soon as symptoms begin. If you, or someone you know, think they may have symptoms associated with plantar fasciitis, contact a musculoskeletal specialist for evaluation and treatment.

This article was written by Karen Groulx, PT, DPT from NovaCare/Lincolnwood Clinic.

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