Plantar fasciitis, the heel pain caused by irritation of the connective tissue on the bottom of the foot, can be lingering and intractable. A recent study of novice runners found that those who
developed plantar fasciitis generally required at least five months to recover, and some remained sidelined for a year or more. Until recently, first-line treatments involved stretching and
anti-inflammatory painkillers such as ibuprofen or cortisone. But many scientists now believe that anti-inflammatories are unwarranted, because the condition involves little inflammation. Stretching
is still commonly recommended.
Factors which may contribute to plantar fasciitis and heel spurs include a sudden increase in daily activities, increase in weight (not usually a problem with runners), or a change of shoes. Dramatic
increase in training intensity or duration may cause plantar fasciitis. Shoes that are too flexible in the middle of the arch or shoes that bend before the toe joints will cause an increase in
tension in the plantar fascia. Even though you may have run in shoes that are flexible before, now that you have developed plantar fasciitis, make certain that your shoe is stable and does not bend
in the midfoot. Check and be certain that your shoes are not excessively worn. Shoes that do not sufficiently control excessive pronation combined with an increase in training can lead to this
condition. A change in running style or parameters, such as starting speed work, running on the ball of your foot or sudden increase in hill workouts may lead to problems. All changes should be
gradual and not abrupt. Gait changes such as altering your foot strike, switching shoe style, running barefoot or in minimalist shoes should all be made gradually and not abruptly. The "terrible
too's" of too much, too soon, too often with too little rest also applies to "too many changes with too little adaptation". Make your changes gradually and allow your muscles, bones, and other body
structures to adapt to the alterations you may be attempting.
Symptoms of the plantar fasciitis include a gradual onset of pain under the heel which may radiate into the foot. Tenderness is usually felt under and on the inside of the heel which is initially
worse first in the morning but eases as the foot warms up only to return later in the day or after exercise. Stretching the plantar fascia may be painful.
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
Teatment of plantar fasciitis can be a long and frustrating process for both the coach and athlete. If you do not have a firm grasp of the goals of this rehabilitation program your best advice will
be to find a professional who routinely deals with athletic injuries. The "down time" for plantar fasciitis will be at least six weeks and up to six months of conservative care before drastic
measures like surgery should be considered. The goal of this rehab program is to initially increase the passive flexion of the foot eventually leading to improvements in dynamic balance and
flexibility of the foot and ankle, followed by a full return to function.
When more-conservative measures aren't working, your doctor might recommend steroid shots. Injecting a type of steroid medication into the tender area can provide temporary pain relief. Multiple
injections aren't recommended because they can weaken your plantar fascia and possibly cause it to rupture, as well as shrink the fat pad covering your heel bone. Extracorporeal shock wave therapy.
In this procedure, sound waves are directed at the area of heel pain to stimulate healing. It's usually used for chronic plantar fasciitis that hasn't responded to more-conservative treatments. This
procedure may cause bruises, swelling, pain, numbness or tingling and has not been shown to be consistently effective. Surgery. Few people need surgery to detach the plantar fascia from the heel
bone. It's generally an option only when the pain is severe and all else fails. Side effects include a weakening of the arch in your foot.
Factors that help prevent plantar fasciitis and reduce the risk of recurrence include. Exercises to strengthen the muscles of the lower leg and ankle. Warming up before commencing physical activity.
Maintaining a healthy body weight. Avoiding high heeled footwear. Using orthotic devices such as arch supports and heel raises in footwear, particularly for people with very high arches or flat feet.
Daily stretches of plantar fascia and Achilles tendon.