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Plantar Fasciitis

One of the most common causes of heel pain, plantar fasciitis occurs when the strong band of tissue that supports the arch of your foot becomes irritated and inflamed. The plantar fascia is a long, thin ligament directly beneath the skin on the bottom of your foot. It connects your heel to the front of the foot.

What causes it?

The purpose of the plantar fascia is to absorb the high stress and strains we place on our feet. But sometimes too much pressure damages or tears the tissue, and our body’s natural response to injury is inflammation, so it results in heel pain and stiffness. Plantar fasciitis often develops for no specific reason, but there are many factors that can make you prone to it:

  • Tight calf muscles, which make it hard to flex your foot and bring your toes toward your shin
  • Obesity
  • Very high arch
  • Repetitive impact activity
  • New or increased activity

How do you know you have it?

The most common symptoms of plantar fasciitis include:

  • Pain on the bottom of your foot near the heel
  • Pain with your first few steps after getting out of bed in the morning or after a long period of rest. The pain subsides after a few minutes of walking
  • Greater pain after (not during) exercise or activity

How we fix it

The OSI foot and ankle team is here to listen, discuss your concerns, and examine you for signs and symptoms of plantar fasciitis. Our goal is to have you back on your feet, pain free, enjoying the activities you love. While you’re under our expert care, you will undergo the following to determine the best course of care:

  • Physical exam: Your doctor will perform a careful exam of your foot and look for high arch, an area of maximum tenderness on the bottom of your foot in front of your heel bone, pain that gets worse when you flex your foot while the doctor pushes on the plantar fascia and gets better when you point your toes down, and limited “up” motion of your ankle.
  • X-rays: An x-ray may be ordered to make sure there are no other causes for your heel pain like fractures or arthritis.

Nonsurgical Treatment

More than 90 percent of patients with plantar fasciitis will improve within 10 months of starting simple treatments. Your Orthopedic and Sports Institute of the Fox Valley doctor can give you the best course of action, here are some tips to relieve your discomfort:

  • Decrease or even stop the activities that make your pain worse.
  • Rolling your foot over a frozen water bottle for 20 minutes is effective.
  • Non-steroidal anti-inflammatory medications. Ibuprofen and naproxen will reduce pain and inflammation, but you should not use them for more than a month without talking to your doctor.
  • Stretching your calves and plantar fascia is the most effective way to relieve the pain that comes with plantar fasciitis.
  • Cortisone injections. This powerful steroid is an anti-inflammatory that can be injected into the plantar fascia.
  • Night splints. Most people sleep with their feet pointed down, which relaxes the plantar fascia and can cause morning heel pain. A night split will stretch the plantar fascia while you sleep and can be very effective.

Surgical Treatment

Surgery is usually only a consideration after 12 months of aggressive nonsurgical treatment. Options will be discussed in detail with your OSI doctor, but they include:

  • Gastrocnemius recession
  • Plantar fascia release

Recovery

Most patients report good results after surgery, but there is a chance of nerve damage and incomplete pain relief after surgery. Because the surgery can result in chronic pain and dissatisfaction, it is only recommended after all nonsurgical measures have been exhausted.

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