Plantar Fasciitis

Plantar Fasciitis

Plantar Fasciitis
If you feel sharp heel pain, you may have plantar fasciitis. It's common among older people and especially among athletes. Plantar fasciitis develops when ligaments that support the arch become strained and the pain and stiffness gets progressively worse. Rest, ice, stretching and pain relievers all help, but you may also need a new pair of running shoes.

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  • 2 Answers
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    A Dr. Michael Roizen, MD, Internal Medicine, answered
    This is one battle you don't want to charge into. In fact, the more you rest your foot, the better, at least for a week or so. Your plantar fascia -- the thick ligament connecting your heel to your toes -- needs a time out, since inflammation (the "itis" in fasciitis) is often from overuse. That's why it's common in runners. A tight Achilles tendon, a high arch, wearing shoes with high heels, poor arch support or worn soles or being very overweight can take a toll on your sole, too.

    Giving your foot a break doesn't mean you have to sit around. Switch to activities like swimming or rowing (indoors or out), or use weight machines that don't press on your feet. Meanwhile, these remedies will ease that hot-coals feeling in your heel:
    • Give yourself a 10- to15-minute ice massage twice a day. Roll your foot back and forth over a can of frozen juice to increase blood flow and help break down adhesions from the inflammation.
    • Take a nonsteroidal anti-inflammatory, such as ibuprofen, for pain relief.
    • Place heel pads (you can find them at the drugstore) in your shoes.
    • Do foot stretches before you get out of bed. That will reduce the pain, which is usually worse when your feet hit the floor in the morning. To do these stretches, sit up, bend forward and try to touch your toes, curling your toes toward your knees. Or just put one leg over the knee of the other, reach for the toes on the upper leg and pull toward you. Hold for 5 minutes.
    • Stretch during the day. Put the ball of the sore foot on a step, hold the railing, and let your heel hang down. Or repeat the above toe stretch.
    • Save the stilettos for weddings and parties -- most short guys think plantar fasciitis is revenge for high heels.

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  • 2 Answers
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    Heel pain from plantar fasciitis may keep you from your normal activities and alter your gait. The change in gait can cause increased force on your feet, knees, hips and back, while causing pain to spread to more joints.
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  • 1 Answer
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    If you have plantar fasciitis, your doctor can diagnose this process clinically by reproducing your pain by applying pressure to this region with a fingertip (no additional imaging or tests are needed). Plantar fasciitis is caused by inflammation of the adjoining tissues on the bottom (plantar surface) of your foot. This pain is localized in front of the calcaneal (heel) bone, in the region between your heel and the arch of your foot.
  • 3 Answers
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    A Dr. Mehmet Oz, MD, Cardiology (Cardiovascular Disease), answered
    Tai_Chi_Plantar_Fasciitis
    Plantar fasciitis can cause intense pain in the foot and heal, but you can get relief by practicing an ancient Chinese martial art. Watch the video as a Tai Chi expert shares with Dr. Oz how a few slow, gentle exercises can help treat plantar fasciitis.
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  • 1 Answer
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    Plantar fasciitis can be treated with rest and ice. Place a frozen water bottle over the bottom of your foot for up to 10 minutes. This will calm the spasm and break up some of the tissue. You could also take any type of anti-inflammatory medication. (This answer provided for NATA by the California University of Pennsylvania Athletic Training Education Program.)
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    Age: Plantar fasciitis most commonly occurs in adults between the ages of 40 and 60. In the elderly, poor muscle strength, breakdown of the heel fat pad, and delayed healing, in combination with excessive flexing of the foot arches, may lead to plantar fasciitis.

    Athletic activity: Plantar fasciitis is among the most common foot and ankle injuries experienced by professional athletes. Running on a regular basis and certain forms of dance (ballet and dance aerobics) may cause this condition to occur earlier in age. Increasing weight-bearing activity, duration of runs, and stress-inducing workouts may bring about plantar fasciitis. Training on hard or uneven surfaces or with inadequately supportive footwear may increase the risk of developing plantar fasciitis in athletes.

    Body weight: In nonathletes, being overweight, obese, or pregnant is a risk factor for plantar fasciitis. Patients with a body mass index (BMI) greater than 30kg/m2 (kilograms per square meter) are reported to be at the greatest risk.

    Diabetes: In patients with diabetes, plantar fasciitis may occur due to muscle atrophy, anatomical changes in the foot, and changes in gait.

    Foot abnormalities: Flat-footedness, having too high of a foot arch, heel spurs, or a tight Achilles tendon (which connects the calf to the heel) may increase the risk for plantar fasciitis. Patients who have high or flat arches and a limited range of motion during dorsiflexion (flexing the foot upwards) may have the highest risk of the condition.

    Footwear: Wearing inappropriately sized or insufficiently supportive footwear for the heel and arch may lead to the development of plantar fasciitis.

    Occupation: Occupations that involve spending a long amount of time on the feet, either walking or standing, may increase the risk of developing plantar fasciitis.

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    • 1 Answer
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      A Dr Christopher Chiodo, MD, Orthopedic Surgery, answered

      Some foot care specialists have begun using extracorporeal shock wave therapy to treat plantar fasciitis. Shock wave treatment entails one to three sessions during which  low or high-energy sound waves are directed at the painful part of the plantar fascia. This technique is similar to the one used to break up kidney stones, but does not direct sufficient energy at the foot to break up the heel bone or any heel spurs.

      Some studies have reported that the technique relieves pain in 60% to 80% of those treated, while causing only minimal complications or side effects, which can include periodic pain in the treated area. Other studies have shown only limited benefit. This technique is gaining acceptance, however. Talk with your own foot care specialist about the latest research and whether shock wave treatment is right for you. Also be aware that many health insurers do not cover this technology, so you may want to check your own coverage before undergoing treatment.

    • 1 Answer
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      A Dr James Ioli, DPM, Podiatric Medicine, answered
      In extreme cases of plantar fasciitis or - pain in the plantar fascia, surgery may be necessary, but this is recommended only if you are still experiencing substantial pain after six to 12 months and all other methods are exhausted. If so, the surgeon will –release part of the plantar fascia to eliminate the pain. Rarely, a surgeon may remove the -degenerated portion. - Endoscopy, a minimally invasive technique, can sometimes be used to release the plantar fascia. Potential complications from either an open or endoscopic procedure can include arch collapse or damage to a branch of the posterior tibial nerve, which can lead to persistent recurring pain. If you are considering surgery, you should discuss these risks with your doctor.
    • 1 Answer
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      A Dr Christopher Chiodo, MD, Orthopedic Surgery, answered
      If you have plantar fasciitis or inflammation of the plantar fascia, it may help to do gentle stretching exercises to restore suppleness. You can also try purchasing over-the-counter cushion inserts and wearing supportive low-heeled shoes to ease the pressure on your heels. If you continue to experience discomfort after six to eight weeks, consult a foot care specialist, who may recommend further stretching exercises, physical therapy, or night splints.
    • 1 Answer
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      A Dr Anthony Komaroff, MD, Internal Medicine, answered
      Your symptoms sound like plantar fasciitis.

      The plantar fascia is a tough band of tissue. It runs from the heel along the sole of the foot toward the toes. This common and painful condition is due to tears and inflammation of the plantar fascia. People usually complain of pain when they walk, especially after a period of rest.

      Although this often occurs without any other associated condition, it is more common in people who are overweight, have flat feet, or after periods of prolonged standing, jumping or running. There is also an association between plantar fasciitis and diabetes.

      The only way to know you have plantar fasciitis is to see your doctor. X-rays and blood tests are usually not helpful in diagnosing this condition.

      Treatment options include:
      • rest
      • a change in activities
      • a change in the type of shoes
      • physical therapy (which may include stretching, exercises, or ice massage)
      • arch supports (especially if you have flat feet)
      • anti-inflammatory drugs, such as ibuprofen or naproxen
      • weight loss (this may reduce the chance that plantar fasciitis will return)
      • good control of diabetes (although the effect of this on plantar fasciitis is uncertain)
      Overall, these measures are quite successful. See a podiatrist or an orthopedist for cases that do not respond quickly. Other treatments may include:
      • prescription footwear
      • a cast
      • shoe inserts
      • cortisone injections
      • surgery (rarely)