Plantar fasciitis is a common ailment often heard in the news for its effect on athletes but has the potential to affect non-athletes just as well.   Anatomically, the plantar fascia refers to tissue on the bottom surface (plantar surface) of the foot that spans from the heel all the way to the toes.   The area where the tissue attaches at the heel can become inflamed producing heel pain.  With plantar fasciitis the pain often manifests itself when first standing or walking in the morning.  This is because overnight or even after long periods of sitting, the plantar fascia tenses up so when standing and placing pressure on the fascia the pain is exacerbated.

There are risk factors in the development of plantar fasciitis including certain sports like running where there is continuous stress placed on the plantar fascia.  Obesity is also a risk factor since the increased weight places more pressure on the plantar fascia.  Shoe gear can also influence the development of plantar fasciitis.  Shoes with decreased arch support or a poor fit can increase the stress placed on the fascia.  Another risk factor is the biomechanics of one’s foot.  Pronation is a movement that occurs when the foot is rolled inward towards middle of the body so that the outside of the foot begins to lift off the ground.  When a person overly pronates as he or she walks the arch flattens and lengthens, putting tension on the plantar fascia.

Conservative treatment for plantar fasciitis includes applying ice and taking non-steroidal anti-inflammatory drugs to relieve the pain.  Physical therapy and night splints may help stretch the plantar fascia and relieve the tension.  Orthotic devices and padding can also be made to provide support and accommodation.  Steroid injections are also an option to alleviate pain. 

You don’t have to suffer from heel pain.   The physicians at Atlantic Foot and Ankle Associates take a conservative approach for the treatment of plantar fasciitis.  Make an appointment at one of our four offices conveniently located in Palm Coast, Orange City, Daytona Beach, and Port Orange and we’ll have you back on your feet… pain free!

By Dr. Andrew Green, DPM

“Doctor, my heel hurts and I can’t understand why?  It is definitely worse in the morning or after I sit and try to stand up.  It is a sharp pain that is causing me to limp.  I’ve tired different shoes and pads from the foot care isle and nothing is working.”  This is a daily complaint we treat at Atlantic Podiatry Associates in Palm Coast, and is without a doubt one of my favorite things to treat as a podiatrist.  

Our approach to heel pain is simple and effective.  After listening to our patients describe their pain, a thorough lower extremity physical examination is done.  A radiograph allows us to visualize the foot bones to see how the bones and joints interact with the ground.  Radiographs should always be weight bearing.  If there is pain while the toes are bent up and simultaneous pressure of the inner heel, an ultrasound will be performed.  If the ultrasound reveals a thickened plantar fascia, the patient is diagnosed with plantar fasciitis.

To start treatment, our doctors prefer to decrease inflammation of the plantar fascia with an oral anti-inflammatory (Advil or Motrin) or an injectable anti-inflammatory (cortisone) when pain is moderate to severe.  By using an ultrasound, we are certain to inject precisely where the fascia is inflamed using an ultrasound guided technique.  

Stretching the foot after periods of rest is crucial.  A night splint may be worn during leisure times or while sleeping to assist with stretching the foot.  Wearing arch supports, or orthotics, can help stabilize the foot and relieves the pressure of the plantar fascia.  It is very important to be sure the arch supports are somewhat hard or made from a plastic material that may be covered with a softer material.

It is common for athletes with sports injuries to be diagnosed with plantar fasciitis, including pros like Kobe Bryant and Eli Manning.  Sometimes patients need more than one injection, aggressive physical therapy, orthotics, and sometimes surgery.  

As the summer months continue, we love to kick off our running shoes and throw on our sandals.  However, prolonged sandal wearing is a major cause of plantar fasciitis and we encourage everyone to evaluate your shoes of choice.  Match them appropriately to your activity of the day and you may be able to avoid the “summertime” heel pain also known as plantar fasciitis.

By Dr. Dennis McBroom