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.

  

Heel Spur Symptoms and Treatment

A heel spur is a bony formation located at the calcaneous bone or heel bone that can clearly be seen through x-ray. Also called calcaneal spur, this condition is commonly associated with plantar fasciitis when the spur is located at the inferior aspect or at the bottom of the calcaneous bone. 

Though these conditions are related, they are two different disease entities. Plantar fasciitis refers to the irritation or inflammation of the plantar fascia, and a spur usually forms because of this. But not all patients with plantar fasciitis develop a heel spur and not all patients with heel spurs have plantar fasciitis.

Heel spurs are common in patients who suffer from chronic heel pain due to an inflamed plantar fascia. This is often seen on middle aged men and women or among active athletic individuals involved in sports like runners, basketball players and volleyball players.

Patients do not actually complain of heel pain due to heel spurs but from pain due to plantar fasciitis. Most often, a heel spur can only be found or diagnosed through radiological findings where the pointy bony prominence is located at the attachment of the plantar fascia.

How do heel spurs form? About 70% of patients with plantar fasciitis will develop heel spurs. The plantar fascia, which is located at the bottom of the foot, is a strong fibrous tissue that attaches to the heel bone to the balls of the foot.  It is responsible for the arch of the foot and plays a major role in the biomechanics of the foot. This fascia is also constantly under tremendous stress when walking, running or bearing weight.

However, this important structure is very prone to injury and degenerative changes. The natural wear and tear of this tendon can cause irritations and inflammation causing chronic heel pain. For some reason, the new bone growth is formed at the attachment of the plantar fascia to the heel bone probably because of the constant stressful pulling action.

Treating pain associated with heel spurs and plantar fasciitis can be done conservatively. Most often, the R.I.C.E. method which stands for rest, ice, compress, and elevate can effectively relive pain. Other treatments are foot inserts, pain medications and steroid injections. 

A new treatment called ESWT uses multiple shock waves to naturally stimulate healing in the injured fascia. This is a holistic approach since it encourages the own healing properties of the body.

For more information about heel spurs and plantar fasciitis, please visit the Family Foot and Leg Center in Naples or Contact Dr. Kevin Lam at (239) 430-3668.

Heel Pain In Cyclers

Cyclists do not commonly experience heel pain, but if they do have it, it is mainly because of over straining while pedaling. During a typical two hour cycling ride, a cyclist will be to make 83 crank revolutions per minute and that’s a total of 10,000 cranks revolution in two hours. This puts a considerable amount of stress to the calf muscles and feet while pushing against the pedal, especially when going uphill. 

The most common type of heel pain a cyclist can encounter is a strain to the Achilles tendon. The Achilles tendon is the largest tendon in the body. It attaches behind the calcaneus or heel bone and attaches to the calf muscles above. The pain commonly occurs at the attachment of the Achilles tendon to the heel bone. Commonly referred to Achilles tendinitis, this is the inflammation behind the heel causing pain, swelling, tenderness and heat when the touched.

Another common cause of heel pain among cyclers involves the plantar fascia. This fascia runs underneath the foot and also attaches at the bottom portion of the heel bone to the balls of the foot. It is responsible for the arch of the foot and is very important for its biomechanics. This too is a strong tendon and is constantly under stress when walking and running. This is a particularly common among runners but it too can occur among cyclist.

The reason why cyclers experience heel pain is due to erroneous training, failing to do stretching exercises before bicycling, wrong positioning, poor equipment, random peddling and improper footwear.  Error in training is a result of apply too much intensity too soon. Stretching is an important pre training measure in preventing injury. Foot positioning while pedaling is important, so as not to strain any muscles or tendons. Using worn out shoes do not provide much support and cushioning, and can irritating the plantar fascia.

Treatment primarily involves identify the specific foot problem. Visiting a podiatrist is best for these situations and they can also assist and give advice in of the do’s and donts of proper foot care whether in training or not.