Plantar Fasciitis

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Plantar fasciitis is an inflammation of the tissue that extends from the heel to the ball of the foot. The plantar fascia absorbs the stresses placed on the foot during walking, running, and jumping. When irritated, the plantar fascia causes a sharp pain under the heel and sole of the foot. The pain is often worst when stepping onto the foot, especially when first getting out of bed in the morning or when getting up after being seated for some time. Plantar fasciitis is usually caused by shoes that do not fit, excessive athletic training, stress on the arch of the foot, weakness of the foot, or some combination of tightness of the foot and calf. Other possible factors that may increase the risk of plantar fasciitis include obesity, prolonged standing, and limited ankle flexibility.

Home Management Includes:

• Wear shoes with more arch support. Sometimes, arch supports or special shoe inserts may be used to cushion and support your heel.
• Athletes and active people may need to rest and limit activities that cause repetitive impact to the heel such as walking, running, jumping, and marching.
• Stretching and strengthening exercises are an important part of the treatment for plantar fasciitis and must be done daily at least until you have had no symptoms for three months. Some of these include:
  Plantar Fascia Stretch – sit with your ankle resting on your opposite knee. Grasp your toes and pull them gently backward until a stretch is felt in the arch of your foot. Hold for 30 seconds and repeat six times. Doing this exercise two to three times a day will help prevent future episodes of pain.
  Towel Curl – sit with your foot flat on the end of a towel placed on a smooth surface. Keeping your heel on the floor, pull the towel toward your body by curling up the towel with your toes.
  Marble Pick-ups – put a few marbles on the floor near a cup. Keeping your heel on the floor, pick up the marbles with your toes and drop them in the cup.
  Toe Taps – you will lift all your toes off the floor and, while the heel is on the floor and the four toes are in the air, tap the big toe to the floor. Next you will change the order and tap the outside four toes to the floor a number of times while keeping the big toe in the air. Start with 10 taps and work up to 50 taps per session.
• An ice massage or ice pack can help with inflammation. Rub ice over the painful heel using a circular motion and medium pressure for 5-10 minutes. An ice pack can be made by putting crushed ice in a plastic bag wrapped in a towel and molding it to the foot. Use the ice pack for 20 minutes up to four times daily. Applying ice to your heel after exercising, stretching, strengthening, and working can help with symptoms.
• A night splint, which also may be helpful, is a hard plastic splint that is worn at night to maintain your foot and ankle in a neutral position after stretching. Splints can be found at most drug or medical equipment stores and help speed healing.
• Other treatments, that your Osteopathic Family Physician may prescribe, include Osteopathic Manipulative Therapy, anti-inflammatory medication, cortisone shots into the heel to decrease pain, casting, shock wave therapy, and surgery. Please talk with your doctor about the possible benefits, risks, and side effects of these treatments.

Medical Care & Treatment Options:

If you have any questions about plantar fasciitis, please contact your Osteopathic Family Physician. Your physician can diagnose plantar fasciitis with a thorough history and physical exam along with appropriate tests. Management includes the right treatment plan and regular visits with your doctor. Your family doctor will help you choose which current recom- mended treatment(s) will work best for you. In case of any emergency, you should call your doctor or 911 right away.

SOURCE(S): American Family Physician, Plantar Fasciitis. Gov, and Up-To-Date.