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Plantar fasciitis

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VOL: 101, ISSUE: 12, PAGE NO: 31

What is it?


What is it?
- Plantar fasciitis is inflammation of the plantar fascia, which stretches from the heel to the middle bones of the foot.



- Injury usually occurs close to the heel bone.



Risk factors



- Plantar fasciitis mainly affects people who are over 40 and is more common in athletes and women - particularly in those who wear high heels.



- It is more likely in people who:



- Have done lots of walking, running or standing to which they are unaccustomed;



- Wear shoes with poor cushioning;



- Are overweight or gain weight suddenly;



- Experience tightness of the Achilles tendon.



- Often there is no obvious cause, particularly in older people.






- Pain on the underside of the foot, often about 4cm in front of the heel.



- The pain usually eases on resting but is often worst in the morning.



- Gentle exercise may ease the pain as the day goes by, but prolonged walking often exacerbates it, as does stretching, for example when walking upstairs.






- Inflammation and pain usually ease eventually, but this may take several months.



- Avoid running, excess walking or standing and undue stretching of the sole, although gentle walking and the exercises described below may be helpful.



- Avoid walking barefoot on hard surfaces.



- Choose shoes with cushioned heels and good arch support, such as laced sports shoes. Avoid old or worn shoes.



- Use 1cm-thick heel pads and shoe inserts to cushion the heel. If the heel is very tender, cut a small hole in the pad at the site of the most tender spot so that it does not touch anything inside the shoe.



- Painkillers and anti-inflammatory drugs such as paracetamol and ibuprofen often ease the pain. Some people find topical application in the form of a cream helpful.



- Cortisone injections may relieve the pain or even resolve the problem if the above measures are unsuccessful.



- Some people benefit from wearing a splint overnight to keep the Achilles tendon and plantar fascia slightly stretched. This helps to prevent the plantar fascia from tightening overnight.



- Athletes may find ice massage of the heel before and after exercise helpful.



- Surgery may be considered if the pain has not eased after 12 months despite the treatments listed above. However, surgery is not always successful and should be considered as a last resort.






- The aim of exercise is to loosen the tendons and fascia above and below the heel.



- Facing a wall, two to three feet away, lean onto the wall without bending the knees and keeping balls of the feet and heels on the ground. Hold the position for several seconds. Repeat 10 times, five or six times a day.



- Sit in a chair with balls of feet and heels flat on the floor, then flex the foot, keeping the heel on the ground, to stretch the calf and Achilles tendon. Again, hold the position for several seconds and repeat 10 times, five or six times a day.






Patient UK

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