Newsletter Autumn 2006

Plantar Fascia

The plantar fascia is the thick connective tissue which supports the arch of the foot. It runs from the tuberosity of the calcaneus forward to the heads of the metatarsal bones. It is the source of the painful condition of plantar fasciatiis.

What is Plantar Fasciitis
Plantar fasciitis is inflammation of the thick, fibrous band of tissue that reaches from the heel to the toes, supporting the muscles of the bottom of the foot. "Plantar" refers to the bottom of the foot; "fascia" is supportive tissue. When the plantar fascia becomes overly stretched, tiny tears can riddle its surface. The band of fascia can ultimately swell and become quite painful. While some people have attributed this type of pain to bony growths called heel spurs, it is now believed that heel spurs are usually just a coincidental finding in people with plantar fasciitis.



Plantar fasciitis is a painful inflammatory condition caused by excessive wear to the plantar fascia of the foot. The pain usually is felt on the underside of the heel, and is often most intense with the first steps of the day. It is commonly associated with long periods of weight bearing. Obesity, weight gain, jobs that require a lot of walking on hard surfaces, shoes with little or no arch support, and inactivity are also associated with the condition.

Treatments
Many different types of treatment have been effective, and though slow to respond plantar fasciitis has a generally good prognosis. Custom orthotics, preventing excessive pronation of the foot and stress to the fascia. Weight loss if necessary.

Care should be taken to wear supportive and stable shoes. Patients should avoid open-back shoes, sandals, and flip-flops.

Local injection of corticosteroid often gives temporary or permanent relief, but may be painful, if not combined with a local anesthetic. Recurrence rates may be lower if injection is performed under ultrasound guidance.

Night splints can be used to keep the foot in a dorsi-flexed position during sleep to improve calf muscle flexibility and decrease morning pain. Patients should be encouraged to lessen activities which place more pressure on the balls of the feet.