Plantar Fasciitis: Overview
Plantar fasciitis is inflammation of the plantar fascia. The plantar fascia is a thick band of tissue attached to the heel bone that supports the arch of the foot. Plantar fasciitis is caused by activity that puts extra stress on the foot, such as:
The main risk factor that increases your chance of getting for plantar fasciitis is physical activity that stresses the plantar fascia.
Diagnosis
Symptoms of plantar fasciitis may come on gradually or suddenly. Symptoms
include:
The doctor will ask about your symptoms and medical history, and examine your foot. Tests may include an x-ray or bone scan of the foot to help rule out stress fractures or bone spurs.
Treatment Options
Treatments include:Avoid running and other activities that may worsen pain.
Apply ice or a cold pack to the heel and arch for 15-20 minutes, 4 times a day to relieve pain. Wrap the ice or cold pack in a towel. Do not apply the ice directly to your skin.
The following medications can relieve pain and inflammation:
- ibuprofen (Motrin, Advil)
- naproxen (Aleve, Naprosyn)
- acetaminophen (Tylenol)
- aspirin
- corticosteroid injections (may be given by a doctor)
This splint will hold your foot in a neutral position while sleeping.
These special shoe inserts provide support for the mid-arch region of your foot.
Begin stretching exercises to lengthen the Achilles tendon and plantar fascia as recommended by a health care professional.
Prevention
To reduce your risk of getting plantar fasciitis:
How can I prevent plantar fasciitis?
Recurrences of plantar fasciitis may best be avoided by delaying a return to activity until the activity can be performed with no pain. Cross-training techniques offer a solution to interruption of training.
Using a personalized, fitted orthotic device may prevent recurrence of plantar fasciitis. Well-fitting shoes designed for the activity and with appropriate arch support may serve the same purpose. Orthotic devices and shoes must be replaced from time to time as wear dictates. Worn-out arch supports and orthotic devices are of no use and may even be counterproductive.
Tightness of the muscles of the back of the lower leg (calf muscles) exerts tension through the heel cord (Achilles tendon) to the plantar fascia.
Exercises to stretch the calf muscles are preventive as well as therapeutic.
Here are six steps to reduce your risk of plantar fasciitis:
Improving Sports Performance
The key to improving sports performance after a diagnosis of plantar fasciitis is a proper rehabilitation program, and adhering to some of those same principles after the injury is gone.
The single most important aspect of improving performance is stretching before and after you step onto the field, court, ice, or golf course.
Benefits derived from stretching include:
Plantar fasciitis rehabilitation
As an athlete, your number one concern is getting back to full strength as soon as possible so that you can return to training and competition. That is why appropriate rehabilitation is extremely important. Rehabilitation for plantar fasciitis often includes the following:
It's important to stretch and strengthen the injured foot 3 to 4 times a day, beginning when you wake in the morning. For symmetrical development of both legs, and to prevent plantar faciitis in the uninjured foot, exercises should be applied to both the right and left foot.
If pain at the heel or sole of the foot occurs during stretching exercises, back off from the amount of stretch. Pain indicates possible further damage to the already injured fascia.
Tightness of the calf muscles may contribute to plantar fasciitis, so stretching the calf muscles is important to rehabilitation, as is stretching of the plantar fascia itself.
Rehabilitation exercises
The following exercises stretch the plantar fascia, the calf muscles, and the Achilles tendon:
Sit on the floor or ground with both legs outstretched. Use a towel or elastic band and wrap it around the affected foot. Use the towel to provide resistance to upward movement of the forefoot. Pull toes upward with the help of the elastic band, and then allow them to return to the starting position. It's recommended to do ten repetitions several times a day.
Face a wall, standing an arm's length away. Place both hands on the wall. Bend the elbows so that your forehead nearly touches the wall, or until significant stretch is felt in the muscles of the calves. Hold this position for 10 to 15 seconds. Extend elbows and maintain this position for 10 seconds. Repeat this cycle 15 to 20 times.
Strengthening the muscles of the calves may contribute to successful rehabilitation of plantar fasciitis as well as prevent recurrence. The exercises below strengthen calf muscles.
Stand facing a chair back or other supporting structure, resting fingertips on the chair back for balance. Press downward with toes and raise heels fully. Hold this position for 10 to 15 seconds. Relax for 10 seconds. Repeat 15 to 20 times.
When double-toe raises (exercise 3 directly above) can be easily performed 20 times, begin doing single-toe raises. Stand next to a chair back or other supporting structure, resting fingertips on the chair back for balance. Flex the knee of the leg farthest from the chair so that the foot raises completely from the floor. Press downward with the toes of the opposite foot, raising the heel fully. Hold this position for 10 to 15 seconds. Relax for 10 seconds. Repeat 15 to 20 times. Reverse the positions of the legs and perform single-toe raises with the opposite leg.
Alternative exercises
During the period when normal training should be avoided, alternative exercises may be used. These activities should not require any actions that create or intensify pain at the site of injury. They include:
When can I return to my sport or activity?
The goal of rehabilitation is to return you to your sport or activity as soon as is safely possible. If you return too soon you may worsen your injury, which could lead to permanent damage. Everyone recovers from injury at a different rate. Return to your activity is determined by how soon your plantar fasciitis recovers, not by how many days or weeks it has been since your injury occurred.
You may safely return to your sport or activity when, starting from the top of the list and progressing to the end, each of the following is true:
How long will the effects of the injury last?
With proper rehabilitation, a first occurrence diagnosed and treated in its early stages usually lasts a month. If the injury has recurred several times, full recovery may take as long as 6 to 12 weeks.
Recurrences of plantar fasciitis are more difficult to treat. An injury duration of 6 months is not uncommon in recurrent cases. Sometimes, even with aggressive treatment, recovery is delayed for a year or more. Unfortunately, recurrences are fairly common, and a pattern in which plantar fasciitis reappears every several months may evolve.
