Plantar fasciitis, or better termed chronic plantar heel pain, is likely caused by a combination of heel Compression, from standing with weight distributed on the heels. Abnormal stress on the foot,
from decreased ankle flexibility, pronation, or a high BMI. Footwear, particularly a rigid sole and toe spring, which interferes with foot muscle activity, restricts circulation, and hinders the
plantar fasciaâs ability to absorb forces. Contrary to popular belief, the condition is not caused by inflammation in the traditional sense, and supportive footwear is possibly more likely to
contribute to the problem than help it. Plantar fasciitis doesnât develop from overuse or too much stress on plantar fascia. It happens when the wrong kind of stress replaces the good kind of
stress that the foot needs to remain healthy. The aim of treatment therefore should not be reducing stress on the arch. Instead, treatment should focus on changing the types of stresses being applied
and encouraging normal function of the foot.
Plantar fasciitis is a painful disorder in the lower part of your foot usually around the heel. That pain usually hurts as you get up in the morning when you try to stand on your feet, or after any
periods of inactivity. It is a disorder of a tough and strong band that connects the heel bone to the toes. Plantar Fasciitis is caused by injuring that tough band on the bottom of the foot. The
following may be the causes of plantar fasciitis. Tight calf muscles or tight Achilles tendon produces repetitive over-stretching of the plantar fascia. Gait and balance Problem may be a dominant
cause of this disorder. Many people have a special style of walking, with something unique that causes some kind of imbalance in their body. It might be something like locked knees, feet that
turn-out, a weak abdomen etc. This imbalance may place some pressure on the fascia, which eventually causes plantar fasciitis. Weak foot muscles donât give enough support to the plantar fascia. The
small muscles in the foot give the foot its shape by keeping the bones in place and by expanding and contracting to make a movement. Weak foot muscles will allow greater stress on the fascia. Foot
anatomical problems such as flat feet or high arches can make the fascia ligament work or stretch abnormally. Flattening of the fat pad at the sole of the feet under the heels is a Degeneration
process that is caused by poor footwear or by age. Shoes that have no proper heel cup can flatten that fat pad quite quickly and cause this disorder. Walking in shoes which do not have good arch
support is considered to be a cause of plantar fasciitis. Wearing inadequate or worn out shoes may place more stress on the fascia ligament. If you wear shoes that don't fit you by size or width, you
may put your feet under excessive stress. Overweight Men and women are more vulnerable to developing the condition because of the excess weight on the foot. Pregnant women are at risk due to gaining
weight through pregnancy and due to the pregnancy hormones that make ligaments loosen and relax. Sudden increase of activity like starting to run long distance or complete change of daily activity
can cause heel pain and this disorder. Practice of repetitive athletic activities, like long distance running, playing a ball game, dancing or jumping, is a common cause for the disorder. Actually it
is considered as one of the most common running injuries. Spending long periods of time on your feet everyday can cause plantar fasciitis. Working on your feet a few hours a day evey day may be the
reason for your heel pain.
Most people with plantar fasciitis have pain when they take their first steps after they get out of bed or sit for a long time. You may have less stiffness and pain after you take a few steps. But
your foot may hurt more as the day goes on. It may hurt the most when you climb stairs or after you stand for a long time. If you have foot pain at night, you may have a different problem, such as
arthritis, or a nerve problem such as tarsal tunnel syndrome.
Most cases of plantar fasciitis are diagnosed by a health care provider who listens carefully to your description of symptoms. During an examination of your feet, your health care provider will have
to press on the bottom of your feet, the area most likely to be painful in plantar fasciitis. Because the pain of plantar fasciitis has unique characteristics, pain upon rising, improvement after
walking for several minutes, pain produced by pressure applied in a specific location on your foot but not with pressure in other areas, your health care provider will probably feel comfortable
making the diagnosis based on your symptoms and a physical examination. Your health care provider may suggest that you have an X-ray of your foot to verify that there is no stress fracture causing
Non Surgical Treatment
To alleviate the stress and pain on the fascia, the person can take shorter steps and avoid walking barefoot. Activities that involve foot impact, such as jogging, should be avoided. The most
effective treatments include the use of in-shoe heel and arch cushioning with calf-stretching exercises and night splints that stretch the calf and plantar fascia while the patient sleeps.
Prefabricated or custom-made foot orthotics may also alleviate fascial tension and symptoms. Other treatments may include activity modifications, NSAIDs, weight loss in obese patients, cold and ice
massage therapy, and occasional corticosteroid injections. However, because corticosteroid injections can predispose to plantar fasciosis, many clinicians limit these injections. For recalcitrant
cases, physical therapy, oral corticosteroids, and cast immobilization should be used before surgical intervention is considered. A newer form of treatment for recalcitrant types of plantar fasciosis
is extracorporeal pulse activation therapy (EPAT), in which low-frequency pulse waves are delivered locally using a handheld applicator. The pulsed pressure wave is a safe, noninvasive technique that
stimulates metabolism and enhances blood circulation, which helps regenerate damaged tissue and accelerate healing. EPAT is being used at major medical centers.
In cases that do not respond to any conservative treatment, surgical release of the plantar fascia may be considered. Plantar fasciotomy may be performed using open, endoscopic or radiofrequency
lesioning techniques. Overall, the success rate of surgical release is 70 to 90 percent in patients with plantar fasciitis. Potential risk factors include flattening of the longitudinal arch and heel
hypoesthesia as well as the potential complications associated with rupture of the plantar fascia and complications related to anesthesia.
The following steps will help prevent plantar fasciitis or help keep the condition from getting worse if you already have it. Take care of your feet. Wear shoes with good arch support and heel
cushioning. If your work requires you to stand on hard surfaces, stand on a thick rubber mat to reduce stress on your feet. Do exercises to stretch the Achilles tendon at the back of the heel. This
is especially important before sports, but it is helpful for non-athletes as well. Ask your doctor about recommendations for a stretching routine. Stay at a healthy weight for your height. Establish
good exercise habits. Increase your exercise levels gradually, and wear supportive shoes. If you run, alternate running with other sports that will not cause heel pain. Put on supportive shoes as
soon as you get out of bed. Going barefoot or wearing slippers puts stress on your feet. If you feel that work activities caused your heel pain, ask your human resources department for information
about different ways of doing your job that will not make your heel pain worse. If you are involved in sports, you may want to consult a sports training specialist for training and conditioning
programs to prevent plantar fasciitis from recurring.