Plantar fasciitis is an inflammation of the plantar fascia, a broad, flat ligament in the bottom of the foot that extends from the heel all the way through the great toe.
When this structure becomes overstretched it can tear, and these microtears can cause significant amounts of inflammation in the heel. This inflammation in the heel area is called plantar fasciitis.
Plantar fasciitis is a rather common occurrence in those of us who also concurrently have high arches and also those who have flat feet, as any extreme of foot motion can lead to increased inflammation due to too much force or too much movement in this area.
For those with high arches the plantar fascia is generally tight and restricted and is torn via the repetitive strain of impact, concrete floors and the like.
Those with flat feet have excessive motion of the medial longitudinal arch (inside of foot) and this excess motion tears the plantar fascia just as readily.
Treatment of plantar fasciitis consists of anti-inflammatories, anti-inflammatory modalities such as US, iontophoresis and ice, as well as my personal favorite—rolling a frozen water bottle on the sole of the foot.
A night splint is sometimes useful for plantar fasciitis as it prevents the plantar fascia from contracting and re-tearing in the first few steps of the morning.
A night splint pulls the ankle into dorsiflexion (upwards) and prevents this tightening from occurring.
In many cases of plantar fasciitis, the pain is felt most severely the first few steps in the morning. That is because when the plantar fascia is allowed to heal at night, it will ultimately return and will hurt again in the first few steps of the morning.
If we can put shoes by the side of the bed, we can prevent the plantar fascia from being re-torn in the morning and thus facilitate healing.
Another very useful tool in the treatment of plantar fasciitis is low dye strapping.
This type of taping decreases the force on the plantar fascia and allows it to heal.
Trigger point dry needling is also extremely effective as are custom or non-custom foot orthotics (arch supports that prevent and decrease the repetitive stretching and tearing of the plantar fascia.)
Steroid injections are often extremely effective in the treatment of plantar fasciitis as well and can facilitate healing.
As you can see, there are several types of plantar fasciitis for several types of feet and also specific types of treatment that can be useful.
A consultation with a foot specialist is always a good starting place. For more information on plantar fasciitis, or care and treatment, please feel free to contact the clinic for a no cost consultation.
(Dr. Mark McDonald, PT, DPT, OCS is a lifelong Sterling native and board certified orthopedic physical therapist with 21 years practice in Sterling. He is a clinical partner with AB Fitness/Alma Blagg, Devonshire Acres, and Northeast Plains Home Health Care in Sterling.)