Plantar Fasciitis
Plantar fasciitis is often seen in runners and people who are
active in sports. Symptoms of plantar fasciitis may include a dull pain
in the back of the foot where the plantar fascia, a thick fibrous material
on the bottom of the foot attaches to the heel bone. Often the pain will
begin as a dull intermittent pain and over time may progress to a sharp
pain that it is more persistent. Pain is usually worse in the morning or
after you have been resting, standing or walking.
The condition usually develops
due to repeated stress on the plantar fascia when you run or do some other
activity. With every step, stress causes the problem to become worse. The
heel may be visibly swollen.
Spike-like pieces of new
bone, called heel spurs, can form at the heel bone as a result. These spikes
may be visible on x-rays, but they do not initially cause pain. However,
after the spurs have formed, walking on the heel spurs can cause sharp
pain.
Some of the factors that
contribute to plantar fasciitis include:
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Having flat feet
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Having high-arched feet
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Wearing shoes with poor support
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Running on your toes
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Running on soft terrain
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Age
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Sudden increase in weight
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Sudden increase in activity
level
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Heredity
Getting relief from Plantar
Fasciitis may take quite some time, particularly if you have had the condition
over a long period of time. Losing weight, wearing a good shoe, and reducing
your activities can help the healing process. Remember to return to activities
slowly.
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Rest. Pain should be your guide
to how much activity is enough. If your foot hurts, you need to rest it.
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Ice. Apply an ice pack wrapped
in a towel to the affected foot for 30-60 minutes several times a day.
Also, ice the area for 15 minutes after activities.
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Medication. Anti-inflammatory/analgesic
medications and heel pads may help alleviate the pain and inflammation
if your condition has just developed. However, if after two or three weeks
you experience no relief, you need to see your doctor. Your doctor may
use steroid injections or a local anesthetic injected directly into the
tender area to relieve the pain.
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Physical Therapy. In some cases,
physical therapy may be used to decrease the inflammation. After the inflammation
has subsided, therapy can be used to strengthen the small muscles of the
foot that support the plantar fascia.
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Heel Pads. A heel pad, made
of felt, sponge, or a synthetic material, can help even out and absorb
the impact when your heel lands each time you step. It may be necessary
to cut away the portion of the heel pad that touches the affected area
of your foot, to avoid further irritation. Heel pads are available at most
medical supply and sporting good stores.
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Shoes. Good running shoes with
firm support are the best type of shoes to wear. A good fit is also important.
You may need to try different shoes to find the type of shoe that is best
fitted to your foot.
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Orthoses. Your doctor may prescribe
shoe inserts called orthoses.
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Taping. Taping your foot can
help maintain the arch and also take some of the stress from the plantar
fascia.
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Surgery. In rare instances,
surgery may be required if all other conservative methods of treatment
have failed, and the pain is incapacitating. If surgery does become necessary,
the bone spur is removed and the plantar fascia released.
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Sports. Any weightbearing activity
will affect plantar fasciitis. Sports where the foot is impacted each time
it lands can be particularly problematic. Again, sudden weight gain, a
return to activities after a lack of activity over a period of time, or
just a sudden increase in activity can also lead to plantar fasciitis problems.
To avoid these complications,
while your injury is healing, you should maintain your cardiovascular fitness
by replacing your normal activities with non-weight bearing sports such
as swimming and biking. Weight training can also be helpful.
When you decide to return
to weightbearing activities, be sure to start slowly and let pain be your
guide as to how much you can handle. If you are in pain during the activity
or the following morning -- you need to cut back.
Heel pads in your shoes or
changing your shoes may help the problem.
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