Plantar Fasciitis

Information on Plantar Fasciitis by the plantar fasciitis organization..

Plantar fasciitis is the most common cause of heel pain. Plantar fasciitis occurs when the long, flat ligament on the bottom of the foot (plantar fascia) stretches irregularly and develops small tears that cause the ligament to become inflamed. The inflammation is caused most often by walking with an abnormal step (such as pronation which is the abnormal inward twisting of the foot). Over time, this slightly abnormal step may increase tension on the plantar fascia and causes it to become inflamed.

Treatment without surgery is usually successful in relieving the inflammation and pain of plantar fasciitis, especially if treatment is started at the earliest sign of heel pain and other symptoms.

Plantar fasciitis can be aggravated by certain activities that put repeated stress on the plantar fascia ligament. Activities such as prolonged walking or standing, or sports such as running or basketball, can put additional stress on the plantar fascia ligament, resulting in tissue damage. If heel pain is not treated, plantar fasciitis can become long-lasting (chronic) and cause constant heel pain while standing or walking. Other health conditions, such as being overweight, can put additional stress on the ligament.

Plantar fasciitis is a common problem among middle-aged adults and some athletes. Treating the condition usually requires only conservative methods if treatment is begun soon after the symptoms begin.

Plantar Fasciitis Treatment

Traditional remedies & treatment for plantar fasciitis include stretching the calf, massaging, decreasing one's training, losing weight, purchasing better-fitting shoes (with a raised heel and arch support), icing the sore heel, and taking ibuprofen. Plantar fasciitis can often be treated simply by using a special shoe insert that uses acupressure to relieve pain and fascia bar technology to re-stretch the plantar fascia ligament. As stated above, the most recommended treatment by doctors is the HTP Heel Seats.





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Plantar Fasciitis has an array of Causes

There can be many different factors that cause plantar fasciitis. When walking with a normal step, the plantar fascia ligament stretches as the foot strikes the ground. When taking an abnormal step, the plantar fascia ligament can stretch irregularly causing stress and resulting in small tears in the ligament. These small tears can cause the ligament to become inflamed (plantar fasciitis).

The repetitive stress of certain conditions or activities can lead to small tears in the ligament and inflammation. Among the other factors that contribute to plantar fasciitis are having a lack of arch support, inflexible Achilles tendon and calf muscles, obesity, wearing shoes with little or no cushioning and support, or shoes that do not bend enough around the ball of the foot during movement. Walking barefoot on hard surfaces, standing for long periods of time, or suddenly changing or increasing the level of activity or difficulty of exercise can also significantly contribute to plantar fascia injury.

How Plantar Fasciitis & Heel Spurs Progress

Plantar fasciitis usually develops gradually. Heel pain may only occur when taking the first few steps after getting out of bed in the morning or when taking the first steps after sitting for a long period of time. If the plantar fascia ligament is not rested, the inflammation and heel pain will get worse. Other conditions or aggravating factors, such as the repetitive stress of walking, prolonged standing, running, or jumping, will contribute to the inflammation and pain. In some cases, the inflamed ligament may not heal because many people who have plantar fasciitis do not completely stop the aggravating activity.

Most people develop irritation and inflammation of the plantar fascia because of 'overuse' from excessive running, jumping, jogging, or twisting of the feet, resulting in excessive pronation (inner turning of the feet). The injury may also result in small tears of the plantar fascia.

Pain resulting from plantar fasciitis is usually described as being dull aching or sharp and can be reproduced by flexing the toes upwards (dorsiflexion) and tensing the fascia. Symptoms tend to worsen after standing and walking, in the morning after awaking, or after prolonged sitting. This happens because the fascia is being stressed again after a protracted rest. As the person walks, the fascia 'warms up' and lengthens slightly, reducing the tension and the associated pain.

The repetitive stretching of the fascia over years can also irritate the point of insertion of the fascia to the heel bone, leading to the formation of a hook shaped spur of the heel bone. A common misconception is that the heel pain is mostly due to the bone spur. The truth is that the pain is due primarily or exclusively to the inflammation of the fascia (plantar fasciitis) and not to the bone spur because significant heel pain occurs in the absence of spurs, and large bone spurs can be detected by x-rays in people with no heel pain.




What to Watch for With Plantar Fasciitis

There are many risk factors for plantar fasciitis. Age is often a factor, since age causes the plantar fascia tissue to become weakened and overworked over time. Abnormal biomechanics of the foot during movement or having high arches or flat feet are also factors. Among the other factors for developing plantar fasciitis are:
  • Having a sudden gain in weight, or being overweight.
  • Having tightness in the Achilles tendon, which attaches the calf muscle to the heel bone. (Also see Achilles Tendonitis)
  • Certain habits or activities:
    • Wearing shoes with poor cushioning.
    • Walking or running without being conditioned for these activities.
    • Changing a walking or running surface, for example, from grass to concrete.
    • Having a job that involves prolonged standing on hard surfaces.
Athletes, especially runners, are at increased risk for plantar fasciitis. In athletes, a number of factors are associated with development of plantar fasciitis. These factors can cause the athlete to change his or her gait (the way the feet strike the ground), which can cause additional symptoms and injury, as well as injury beyond the heel. Risk factors for athletes include:
  • Decreased flexibility in the foot and ankle
  • Imbalanced muscle strength (muscles in one leg or foot are weaker than the other)
  • Tightness in the Achilles tendon. (Also see Achilles Tendonitis)
  • Repetitive movements and stress common in sports activities
  • Wearing running shoes that are worn out
  • Wearing running shoes that do not have a cushioned sole or enough arch support
  • Abruptly changing the intensity or duration of the running routine


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