Cause and Effect of Plantar Fasciitis

There are over two million cases of plantar fasciitis treated in America every year. It is one of the most commonly treated symptoms addressed by a podiatrist and is slightly more prevalent in women than men. Most cases are reported from people between the age of 40 and 70. The planta fascia runs from the heel bone to the toes. This is a long ligament and is very strong as it supports the arch and springs the energy created by walking/running from the heel to the toes. Just like a carbon fishing rod it is very strong and will flex from up and down but stretch it length wise and the fibers will tear. When this happens pain and inflammation are felt, usually around the heel and arch area at the bottom of the foot.

Symptoms of Plantar Fasciitis:

  • Pain in the morning on the bottom of the foot, near the heel, that will subside after a brief period of walking.
  • Typically the pain develops gradually, but after several weeks, the pain escalates and doesn’t diminish. Most often described as a sharp pain in the heel or arch although some people describe it as a dull pain.
  • Tenderness is felt when pressure is applied to the heel pad or the arch. Most often there is no swelling or bruising.
  • The pain is greater after exercising than during the exercise.

According to –  Over the past two years, our team of doctors has treated more than 2,000 patients with plantar fasciitis. This has allowed us to try multiple conservative and surgical options. We have concluded that certain conservative options seem to make significant improvements.

If I have one conservative option to offer patients on a consistent basis that has the most impact in their recovery from heel pain, it would be Achilles and gastrocnemius stretching. We usually will ask patients to perform both calf and Achilles stretches for five minutes three times per day. We teach the patients these stretches on the initial visit.

Second in line for conservative options is a close tie between physical therapy and orthotic use. We have found that the combination of stretching, physical therapy and orthotic use has helped over 80 percent of our patients recover without further need for care. The average time to recovery has been less than two months and no further treatment has been necessary in over 90 percent of this initial group.

Pain Relief: Bandaging the arch helps but does not last long. Products that support the arch are your best bet. A custom made orthotic made from the mold of your foot will supply cushioning to the heel area and support the arch. Highly recommended is a night splint this will prop the foot up in a 90 degree position, situating the plantar tendon in a shortened position, making it possible for the tears in the plantar fascia to heal. These braces are relatively inexpensive.

Pain Relief: Using Advil or Aleve will help ease the pain but if these don’t work the doctor will most likely, administer an injection of a corticosteroid directly into the fascia tendon. Typically two shots are given anywhere from two weeks to a month apart. The steroid will most likely relieve the pain but do not overexert the fascia because the steroid shot is not healing the tendon, only addressing the pain. The good news is that only around 3% of cases require surgery.