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What is Plantar Fasciitis?

Plantar Fasciitis is heel pain, caused by inflammation of the plantar fascia. It is an overuse injury that affects the sole of the foot. Normally, athletes with plantar fasciitis will complain of foot pain first thing in the morning when they step out of bed. The pain will gradually subside throughout the day. In more severe cases, pain will continue through daily activities as well as with exercise and sport. The plantar fascia is a thick band of connective tissue extending along the sole of the foot.  Plantar fasciitis is two times more common in women than men. It can occur more often in overweight athletes than those of an average weight.

Causes

  • Repetitive impact stresses to the foot, common in runners, gymnastics, and field sports
  • Prolonged standing or walking
  • Larger, more overweight athletes may be more predisposed than lighter athletes
  • Tight calf musculature

Signs and Symptoms

  • Pain in the first few steps in the morning, improves as the day goes on
  • If severe, symptoms with activities of daily living and sport specific activities
  • Pain better with rest and light activity

Treatment

Treatment of plantar fasciitis is aimed at reducing the causative factors, and decreasing inflammation. It is important to treat all possible aspects of plantar fasciitis. Stretching of the lower extremity, especially calf, musculature is important. It is also pertinent to stretch the plantar fascia itself. Use of anti-inflammatories is helpful in decreasing inflammation and can help to reduce pain. Use of a night splint is recommended for athletes whose symptoms do not subside with stretching and anti-inflammatories. The splint keeps the plantar fascia in an elongated position, slowly stretching it over night.

If conservative treatment does not reduce symptoms, more invasive options are available. Steroid injection of the plantar fascia is possible to reduce local symptoms and decrease pain.

Surgical options include a plantar fascia release. Plantar fascia release is a surgical procedure that removes or releases the diseased/inflamed portion of the tissue that is the source of the pain. Fascia release is done for those athletes who have failed all other facets of conservative treatment. Unfortunately, undergoing a plantar fascia release can cause other problems and issues down the road, which are important to consider before going forward.

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