Understanding Plantar Fasciitis

By Vivian C. Iwu, DPM, Choice Podiatry Center

Heel pain is a condition that affects many individuals and is commonly known as plantar fasciitis. A heel spur can make us all victims of pain. Active young children with open growth plates can suffer something called calcaneal apophysitis. Then there’s Achilles tendinitis/bursitis and Haglund’s deformity (a bump on the posterior heel bone). Plantar fasciitis is the most common cause of heel pain and is caused mostly by overuse and excess pressure due to body weight. Most patients with plantar fasciitis feel pain with the first step out of bed in the morning. The pain then gets better after walking, but worsens at the end of the day. Many with this condition say they stand for long periods of time on hardwood or concrete-type flooring.

Plantar fasciitis is the inflammation of the plantar fascial band. The band spans from the inferior aspect of the heel to the ball of the foot. This part of the body is what absorbs the shocks of weight bearing. The medial aspect of the band is the region mostly affected. A plantar fascial problem starts with wear and tear of the band, which causes micro tears, inflammation and pain to the band. When this sturdy thick plantar fascial band becomes inflamed, the fascia contracts and shortens. The body recognizes this shortening over time, and it signals the heel bone to grow extra bone to accommodate for the shortening. As this happens, calcaneal (heel) spurring occurs. It is important to understand that the heel spur is not what causes the pain. The pain comes from the shortening and inflammation of the plantar fascia.

The question then becomes, why does it hurt most with the first step out of bed in the morning or after prolonged rest? When sitting or resting, the foot is contracted and is in a relaxed position, resulting to a shortened plantar fascial band. After being in this relaxed position for the night, when you stand to take a step, the band is forcefully stretched by placing the foot at a 90 degree angle. Meanwhile, applying entire body weight to the same forcefully stretched, previously contracted, shortened and inflamed plantar fascial band, results in the “ouch.”

The pain and problems relating to plantar fasciitis can limit ambulation, and can cause compensation at different foot and ankle joints. Over time, individuals can start experiencing knee, hip and back problems due to altering of the gait. It is very important not to ignore heel pain or plantar fasciitis. Although this problem responds very well with conservative treatment, the key to getting better sooner is seeking appropriate and professional treatment from Foot and Ankle Specialists. Stretching, icing and wearing appropriate shoe gears and inserts are important to getting better. It is also imperative to avoid barefoot walking, as this worsens the problem. One of the newest modalities that can be used in the treatment of plantar fasciitis at the Foot and Ankle specialist office is LASER. For more information, Please contact Dr. Vivian Iwu of Choice Podiatry Center at 678-807-8320.

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