Nathaniel Zimmerman
     CERTIFIED PEDORTHIST
     2127 West 8th
     Erie, PA 16505

  


 
 
 
HELPING YOU "WALK-RITE" ONE STEP AT A TIME
  

 


  Plantar Fasciitis the most common foot problem and one of the hardest to overcome.
  The plantar fascia is a thick fibrous tissue that attaches to the heel bone (calcaneus) and spans across the bottom of the foot and arch, which then attaches to the back of the toes. It acts like a bowstring to maintain the arch of the foot.

 

The Injury

  The fascia endures tension that is two to three times your body weight during walking at the moment when the heel of the trailing leg begins to lift off the ground. This moment of maximum tension is increased and sharpened if there is lack of flexibility in the calf muscles. The problem starts when the fascia is overused and micro tears within the fascia become inflamed, usually at the insertion at the heel resulting in pain. The fascia may tear at the midsole and near the toes as well. Plantar Fasciitis is an ongoing injury process, since it is difficult to rest the foot, and it gradually becomes worse. When sleeping or at rest, the fascia is shortened and tight, as do the calf muscles. Thus upon rising, a painful re-injury occurs. heel spurs are the body's way of attempting to help the fascia to reattach to the heel. The bone calcifies toward the torn tissue to help it heal. Heel spurs do not cause the initial pain, nor do they cause the problem, they are a result of the problem. Spurs do not hurt unless they are very large, fractured, or fat pad atrophy is present.

Contributing Factors

• Flat (pronated) feet
• High arched rigid feet
• Poor shoe support
• Short shoes
• Walking/running uphill
• Soft terrain (sand)
• Increasing age
• Tight calf muscles

 

 

Treatment

  Medication: Most physicians will prescribe an anti-inflammatory to relieve pain. Over-the-counter drugs such as Ibuprofen, Aleve, and Motrin could be used.
  Rest: Listen to your body. If the pain is so debilitating, you may have to stay off your feet for a period of time.
Stretching: It is absolutely necessary to do the stretches at least two times a day to find relief from plantar fasciitis.
  Custom Cushioned Orthotics: For most people a custom orthotic device is necessary to maintain the long arch to keep the plantar fascia as short as possible and prevent further injury.
  Shoes: 80% of the U.S. population unknowingly wear their shoes at least one size too small. The fascia attaches to the backsides of the toe bones, and short shoes cause the toes to contract, which pulls fascia tighter and causes micro tears while walking. Your shoes need at least a half an inch from the end of the shoe to the longest toe while standing. Do not go barefoot while having heel pain.
  Ice: Icing the area for twenty minutes repeatedly is very helpful to reduce the inflammation. It is also important to ice the area fifteen minutes after activity.
  Night Splints: In chronic cases, a dorsiflexion night splint is used. This is a brace that holds the front of your foot pointed slightly toward your knee and keeps your calf muscles stretched while sleeping. This prevents re-injury upon rising.
  Surgery: Surgery is rarely required for plantar fasciitis. It would only be considered if all other treatments fail.