foot/ankle PLANTAR FASCIITIS

DESCRIPTION:

An inflammatory process occurring along the sole of the foot, affecting the connective tissue called the plantar fascia, usually at its attachment on the heel (calcaneus). The plantar fascia runs from the heel to the toes (see illustration).

MECHANISM OF INJURY / HOW IT OCCURS:

Repetitive stretch to the fascia, during impact activities such as running, jumping, etc., resulting in small tears to the fascia.
Walking barefoot on hard surfaces or wearing old athletic shoes can also lead to this injury.
Prolonged weight bearing can exacerbate.

SYMPTOMS:

Individuals present with a complaint of heel and arch pain often most severe with the first step in the morning. (A result of the foot resting in a plantar flexed (relaxed) position overnight with subsequent shortening of the Fascia. The first step results in a stretch to the plantar fascia which is painful).

DIAGNOSIS:

Physical examination demonstrates tenderness along the arch of the foot and heel bone.
May see a heel spur (osteophyte) on x-ray which is a response of the body to the injury, not the cause.

TREATMENT/REHABILITATION:

Rest, ice, anti-inflammatory medications, and stretching remain the mainstay of treatment. It may take several weeks to months to resolve but with a strict program of stretching exercises on a daily basis, sometimes with the assistance of a physical therapist, this problem usually subsides. (See exercises for plantar fasciitis).
Orthotic heel pads are of benefit.
Proper shoe wear and sometimes orthotics supporting the medial longitudinal arch will be of benefit.
Weight loss and occasionally a cortisone injection may afford the individual benefit.
Night splints are sometimes used to maintain the foot in a dorsiflexed position while asleep thus stretching the fascia and decreasing the morning pain.