Plantar Fascitis
Description
Plantar fascitis is characterized by stiffness and inflammation of the main fascia (fibrous connective [ligament-like] tissue) on the bottom of the foot. It is occasionally associated with a bone spur on the heel. Occasionally there may be a partial or complete tear of the fascia of the bottom of the foot. Bone spurs themselves usually do not cause symptoms.
Common Signs and Symptoms
- Pain and tenderness in the sole of the foot, mostly under the heel bone, with standing or walking
- Particularly noticeable pain with the first steps when getting out of bed in the morning or after sitting
Causes
- Stress or injury to the heel tissues, which causes inflammation and calcification of the fascia of the foot
- Irritation of a small nerve that runs under the foot where the main fascia attaches to the heel bone
- Tight calf muscles or flat feet
- Shoes that are poorly fitted, have inadequate arch supports, have with soles that are too stiff, or have rigid arch supports (orthotics)
- Activities that require sudden turns or stops
Risk Increases With:
- Sports, including running or jogging, and sudden stops or changes in direction
- Prolonged standing
- Poor physical conditioning (strength and flexibility)
- Inadequate warm-up before practice or play
- Obesity
- Flat feet
Preventive Measures
- Appropriately warm up and stretch before practice or competition.
- Maintain appropriate conditioning:
- Calf, ankle, and foot flexibility
- Strength and endurance
- Cardiovascular fitness
- Maintain ideal body weight
- Avoid activities that put a constant strain on the foot
- Wear appropriate shoes with a rubber or felt heel cushion and good arches or cushioned arch supports
Expected Outcome
This condition is usually curable with appropriate conservative treatment. If not, heel spurs are often curable with surgery.
Possible Complications
- Frequent recurrence of symptoms, resulting in a chronic problem; appropriately addressing the problem the first time decreases frequency of recurrence
- Lower back or knee disorders caused by constant limping
- Pain or weakness of the foot during push-off following surgery
- Chronic inflammation, scarring, and partial or complete fascia tear, occurring more often from repeated injections
