Plantar fasciitis is a common cause of heel pain in adults. The disorder classically presents with pain that is particularly severe with the first few steps taken in the morning. In general, plantar
fasciitis is a self-limited condition. However, symptoms usually resolve more quickly when the interval between the onset of symptoms and the onset of treatment is shorter. Many treatment options
exist, including rest, stretching, strengthening, change of shoes, arch supports, orthotics, night splints, anti-inflammatory agents and surgery. Usually, plantar fasciitis can be treated
successfully by tailoring treatment to an individual's risk factors and preferences.
It usually starts following an increase in activity levels. Increase in weight. Standing for long periods. Poor footwear. Tight muscle groups. Abnormal pressure on the plantar Fascia can be caused by
any of the above. The plantar fascia becomes inflamed and tiny rips can occur where it attaches into the inside of the heel bone. The area becomes inflamed and swollen, and it is the increase in
fluid to the area that accumulates when weight is taken off the area that then causes the pain on standing.
Among the symptoms for Plantar Fasciitis is pain usually felt on the underside of the heel, often most intense with the first steps after getting out of bed in the morning. It is commonly associated
with long periods of weight bearing or sudden changes in weight bearing or activity. Plantar Fasciitis also called âpolicemanâs heelâ is presented by a sharp stabbing pain at the bottom or
front of the heel bone. In most cases, heel pain is more severe following periods of inactivity when getting up and then subsides, turning into a dull ache.
Your doctor will check your feet and watch you stand and walk. He or she will also ask questions about your past health, including what illnesses or injuries you have had. Your symptoms, such as
where the pain is and what time of day your foot hurts most. How active you are and what types of physical activity you do. Your doctor may take an X-ray of your foot if he or she suspects a problem
with the bones of your foot, such as a stress fracture.
Non Surgical Treatment
Your doctor will determine what treatment is best for your condition. The most common treatments for plantar fasciitis include icing the affected area, inserting custom-made orthotics into your
shoes, massaging the plantar fascia, nonsteroidal anti-inflammatory drugs (NSAIDs), steroid injections, strengthening the foot, wearing a night splint, wearing shoes with arch support, physical
therapy, stretching the calf muscles, shockwave therapy or radiotherapy. To keep the plantar fascia lengthened as you sleep, your doctor may ask you to wear night splints. In the morning, taking your
first steps is less painful because the plantar fascia remains stretched throughout the night. Avoiding activities such as walking or running helps the healing process. Losing weight, if it is a
factor in the condition, may help to reduce the stress placed on the plantar fascia.
Surgery is rarely needed in the treatment of plantar fasciitis. The vast majority of patients diagnosed with plantar fasciitis will recover given ample time. With some basic treatment steps, well
over 90% of patients will achieve full recovery from symptoms of plantar fasciitis within one year of the onset of treatment. Simple treatments include anti-inflammatory medication, shoe inserts, and
stretching exercises. In patients where a good effort with these treatments fails to provide adequate relief, some more aggressive treatments may be attempted. These include cortisone injections or
extracorporeal shock wave treatments.
The following exercises are commonly prescribed to patients with this condition. You should discuss the suitability of these exercises with your physiotherapist prior to beginning them. Generally,
they should be performed 2 - 3 times daily and only provided they do not cause or increase symptoms. Your physiotherapist can advise when it is appropriate to begin the initial exercises and
eventually progress to the intermediate and advanced exercises. As a general rule, addition of exercises or progression to more advanced exercises should take place provided there is no increase in
symptoms. Calf Stretch with Towel. Begin this stretch in long sitting with your leg to be stretched in front of you. Your knee and back should be straight and a towel or rigid band placed around your
foot as demonstrated. Using your foot, ankle and the towel, bring your toes towards your head until you feel a stretch in the back of your calf, Achilles tendon, plantar fascia or leg. Hold for 5
seconds and repeat 10 times at a mild to moderate stretch provided the exercise is pain free. Resistance Band Calf Strengthening. Begin this exercise with a resistance band around your foot as
demonstrated and your foot and ankle held up towards your head. Slowly move your foot and ankle down against the resistance band as far as possible and comfortable without pain, tightening your calf
muscle. Very slowly return back to the starting position. Repeat 10 - 20 times provided the exercise is pain free.