What Is Plantar Fasciitis And How To Treat It

Plantar fasciitis is a debilitating condition which involves injury and inflammation of the plantar fascia. This is a thick connective tissue found underneath the foot, which is very important in maintaining the foot's arch.

There a lot of causes of plantar fasciitis but the patients that mostly have this condition are athletes and the elderly. People engaged in sports that involve intensive use of the feet like runners, cyclers, basketball and football players, and the like can injure the plantar fascia due to excessive stress to the feet. The plantar fascia, as with any part of the body, is prone to wear and tear, so it is typical to find elderly patients with foot problems.

Symptoms of plantar fasciitis are heel pain on the first steps after getting out of bed in the morning or stepping out of a car. Pain gradually deceases after a few steps but pain could heighten up again during the day especially after long periods of standing or climbing the stairs.

A thorough physical exam and past medical history is necessary for a podiatrist to properly diagnose foot pain due to plantar fasciitis. There are different causes of foot pain that can show similar symptoms as that of plantar fasciitis. A correct diagnosis is the key to proper treatment.

There are several approaches in treating heel pain and the goal is to relieve the forces that are causing the plantar fascia to be stretched excessively. At home, there are easy ways to relieve foot pain. Resting the foot is an effective way to stop the pain. If the foot is allowed to rest long enough, this can encourage healing of the plantar fascia. Ice packs or cold compress provide quick relief of pain and swelling. If pain still persists after these basic treatments, then a podiatrist should be consulted.

  

Common Cause Of Foot Pain

Our feet are probably the most abused parts of the body. We use our feet the moment we get out of bed, it bears the weight of the whole body and imagine the tremendous stress we put on our feet when we run or lift heavy loads.  

It is no wonder why we experience foot pain every now and then. But if foot pain does not go away in a few days, you may have a foot condition that’s causing all your pain.

Plantar fasciitis is one of the common causes of chronic heel pain. The plantar fascia is a very strong connective tissue that attaches to the calcaneous bone or heel bone to the metatarsal bones, and is responsible for maintaining the arch of the foot. Usually, the plantar fascia gets micro injuries when using the wrong footwear, lifting heavy weights, sports and due to old age.

Another common cause of foot pain is Achilles tendinitis. The Achilles tendon is also a very strong ligament, just like the plantar fascia. This time, the Achilles tendon is found behind the foot, and it attaches behind the heel bone to the gastrocnemius and soleus muscles above. Just like the plantar fascia, the Achilles tendon can also suffer from micro injuries which causes a lot of pain.

One way to manage foot pain is to do the RICE method. 

Rest. Allowing the foot to rest is very important to stop further injuries to the plantar fascia or Achilles tendon. This will allow the micro injuries to heal.

Ice. Applying cold stimuli to the foot can relieve pain and inflammation. Do this in 2-3 minute intervals, too much isn’t good too, because it can actually aggravate the pain.

Compression. Wrapping the affected foot with an elastic bandage is a good way reduce swelling, it is also good in immobilizing the foot. Remember not to wrap the bandage too tight.

Elevate. Elevating the foot above the heart is an excellent way to alleviate swelling of the foot. This prevents any “pooling” on the affected foot.

Common Causes of Heel Pain

Heel pain is a very common condition. About 70% of Americans are not able to do much activities or exercise simply because of heel pain.  There are two kinds of pain associated with the heel. Posterior heel pain or pain behind the heel, which involves the attachment of Achilles tendon to the heel bone. Inferior heel pain or pain underneath the foot is caused by an inflammation or irritation of the plantar fascia.

There are several causes of heel pain:

Achilles tendinitis

Bone bruise

Bone cyst

Bone fracture

Bone spurs

Bursitis

Gait problems

Gouty arthritis

Heel pad wear and tear

Neuroma

Osteomyelitis

Peripheral neuropathy

Pinched nerve

Plantar fasciitis

Rupture of the Achilles tendon

Rheumatoid arthritis

Stress fractures

Tarsal tunnel syndrome

Tendinitis

Of all the causes of heel pain, plantar fasciitis and Achilles tendinitis are the most common.

Plantar fasciitis is the inflammation or irritation of the plantar fascia. The plantar fascia is a strong fibrous tissue that inserts at the heel bone and to the toes of the foot. It plays an important role in the biomechanics of the foot because it is responsible for maintaining the arch of the foot.

The plantar fascia can get irritated because of overuse. Usually, patients involved in sports or those who are overweight are affected because of the increased amount of stress on the plantar fascia. It is also prone to degenerative process of aging. The older we get, the weaker the fascia.

The Achilles tendon is a strong fibrous tissue that also attaches to the heel bone. Unfortunately, this too is prone to irritation and inflammation because of overuse. This condition is called Achilles tendinitis. Achilles tendinitis is more of a sports injury seen in runners, basketball players, and volleyball players and people involved in any sports that would cause strain on the tendon and calf muscles.

Resting the foot and allowing it to heal is the best treatment for both conditions. But if foot pain is ignored, which most patients commonly do, it can lead to chronic heel pain, where more complicated treatment modalities are needed.

If you have any question about heel pain or any other foot and leg condition please visit the Family Foot and Leg Center in Naples, FL or contact Dr. Kevin Lam at (239) 430-3668 for more details.

How To Deal With Achilles Tendinitis

The Achilles tendon is the largest tendon in the body. Unfortunately, it is also vulnerable and prone to injury. It attaches at the back portion of the calcaneus bone or commonly called the heel bone to the calf muscles of the lower leg. Tendons are strong fibrous tissues that have limited flexibility making them prone to inflammation, irritations, tears or rupture.

Achilles tendinitis is the medical condition where the Achilles tendon becomes irritated or inflamed causing heel pain at the back portion of the foot. This occurs because of overuse of the tendon and is commonly seen on athletes. Overuse or pushing the tendon to its limits causes minute or micro injuries within the tendon. In some cases, a tear can occur or worse, total tear can occur where the calf muscles are totally detached from the heel bone. 

The most common cause of Achilles tendonitis is ignoring the early signs of tendon injury and continuing activity despite of the pain. In some cases when pain is already severe, patients tend to take pain killers and continue with their daily activities. This is an erroneous practice and any foot pain should be taken seriously because this can lead to chronic heel pain, which could be debilitating later on.

Achilles tendonitis is easily treated by basically allowing the foot to rest. This gives the Achilles tendon ample time to heal any injury involved.  Also, cold compress can help with the pain and can suppress any swelling. Calf stretching and massage can help reduce muscle tension on the Achilles tendon.

Some modalities like ESWT or extracorporeal shockwave therapy is an excellent non-invasive treatment especially for chronic heel pain. This machine sends multiple ultrasonic shock waves to the heel producing microscopic injuries. This in turn improves circulation because this creates vasculogenesis or new blood vessel growth. ESWT uses the own regenerative healing properties of the body to treat chronic heel pain. Pain relief is instantaneous in some patients after one treatment, while others will experience a tingling sensation and significant pain relief.

Posterior Heel Pain Due To Achilles Tendinitis

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Posterior heel pain can be due to many different factors but the most common cause of heel pain at the back of the heel is Achilles tendinitis.

The Achilles tendon is a fibrous tissue located behind the foot and attaches to the heel bone to the calf muscles. It is the strongest and thickest tendon in the body and provides various roles from balancing and providing elastic energy in running, walking and hopping.

With each step, the Achilles tendon may be subjected to 3 to 12 times the body weight. Although tendons are tough, they are not very flexible which makes them vulnerable to tears, ruptures, or inflammation.

Achilles tendinitis is the inflammation of the Achilles tendon. This occurs when the tendon becomes irritated and inflamed causing severe pain behind the foot. Achilles tendinitis is often related with running or jumping injuries and other sports-related foot injuries. Sometimes, the strain associated with these activities is so severe that it can cause soreness and stiffness which later progresses if left untreated.

The pain in Achilles tendinitis is at the back of the leg and above the heel. There can be mild swelling on the area plus tenderness that usually improves with mild activity. If you feel tendon pain, discontinue rigorous activities involving the foot. Instead, gentle stretching can be done.

When pain is felt, an ice pack can be placed over the area. NSAIDs or over-the-counter nonsteroidal anti-inflammatory medications can be taken. Always take into consideration that wearing the wrong shoes can induce more injury.

It is imperative that you consult a podiatrist  if the pain becomes severe or causes disability. Other instances that necessitate a visit to the physician include sudden, severe heel pain, inability to bend the foot downward, not being able to walk on your toes, failure to walk normally, or if you cannot put weight on your foot.