Plantar Fasciitis – Causes and Treatment

Plantar Fasciitis – Causes and Treatment

Plantar fasciitis is pain and inflammation of the plantar fascia, a thick band of connective tissue that runs along the heel to the toes which helps to maintain the arch of the foot.

Common symptoms include pain along the arches of the foot or at the heel. In some cases, there could also be sharp pain upon first stepping out of bed or from sitting, and from increased standing, walking or activity. Plantar fasciitis can be caused by a variety of factors.

  • Foot type and mechanics:

    Flat, flexible feet can result in overpronation, which places an excess stretch on the plantar fascia with every step. High arched feet, on the other hand, have a naturally tighter plantar fascia which results in increased tension along the tissue with gait.

  • Activities:

    Work duties that require long hours of standing or walking, intense activity or carrying heavy loads can increase strain on the plantar fascia.

  • Footwear:

    Weak, unstructured footwear with a lack of cushioning does not provide the foot with enough support, hence placing more stress upon the foot to maintain stability. Wearing footwear such as high heels also places the tissue at a shorter length which increases tightness.

  • Individual:

    Very tight musculature can create excess pull and strain on the connection tissues. Weight gain also leads to increased load on the plantar fascia with weight bearing, and age may result in flattening of the arches and thus stretch on the tissue.

Plantar Fasciitis Treatments:

There are many treatment options that can help with plantar fasciitis pain. A consistent treatment plan including all these treatments would allow the plantar fascia to heal quicker, and to help prevent re-occurrence.

  • Custom foot orthotics:

    Depending on the assessment of the foot, custom orthotics can help to provide arch support to a fallen arch to support the plantar fascia, or to improve pressure distribution and cushioning in a higher arched foot.

  • Proper footwear:

    Make sure the shoes have a strong base and heel counter, and cushioning to help with shock absorption. It should not be easily twisted and have good torsional strength. This applies to sandals and slippers as well. Some brands to consider are Sole and Birkenstocks, where the arch is built into the footbed. Or brands such as Naot or Portofino, which have removable footbeds to replace with custom orthotics.

  • Physiotherapy:

    Physiotherapy and other modes of treatment such as massage therapy and acupuncture would help to rehabilitate the muscle to release tension and increase strength.

  • Stretching and massage:

    This is very important to address tight musculature. Basic calf stretches and stretching of the plantar fascia should be done daily.

  • Medication:

    anti-inflammatory pills can help with reducing inflammation and to address pain. At a more severe level, cortisone injections may be suggested by your doctor.

  • Plantar fasciitis night splint:

    Due to the dropping of the forefoot during sleep or rest, the plantar fascia is placed in a shortened position during which it heals. The newly formed tissue is however not yet strong enough in the morning, hence tearing and resulting in sharp pain in the morning. A night splint holds the foot up and keeps the muscles and tissues lengthened so it heals while it is stretched out. This is a very effective tool for morning pain.

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