By Dr. John A. Papa, DC, FCCPOR(C)
Plantar
fasciitis is caused by injury to the plantar fascia, which is the tendon-like
soft-tissue along the bottom of the foot that connects your heel bone to your
toes. This condition is a common source
of heel pain that can be quite disabling.
Under
normal circumstances, your plantar fascia acts like a shock-absorbing rubber
band, supporting the arch of your foot.
Excessive tension and repetitive stretching can create small tears in
this soft-tissue fascia, causing it to become irritated or inflamed. This may occur with activities that require running,
jumping or prolonged walking and standing.
Improper footwear can make the plantar fascia more susceptible to
stretch and strain during these activities.
Faulty
foot mechanics may also contribute to the development of plantar
fasciitis. Individuals with flat feet or
those who excessively pronate (role feet inward) will experience added strain
on their plantar fascia. Old lower
extremity injuries such as ankle sprains and fractures can increase susceptibility
due to altered lower limb movements. Being
overweight is also a risk factor. Carrying
extra pounds can break down the protective fatty tissue under the heel bone, causing
heel pain and putting additional mechanical load on the plantar fascia.
Self-care
strategies for reducing the pain of plantar fasciitis include: ice application;
rolling a tennis ball or soup can from your heel and along the arch of your
foot; and gentle stretching of the achilles tendon, calf muscles, and plantar
fascia. Gel or “donut pads” placed under
the affected heel(s) in shoes may also provide relief.
Plantar
fasciitis that does not respond to self-care strategies may require professional
treatment. This can include
electrotherapy, manual and soft tissue therapy, and specific rehabilitative
exercises for the foot and lower leg. A
custom made orthotic may also be helpful by minimizing pronation, cushioning
the heel, and supporting the arch.
It is important to
establish an accurate diagnosis of plantar fasciitis. Other causes of heel pain may include stress
fractures, achilles tendonitis/bursitis, arthritis, gout, or nerve irritation. If you are having difficulty with heel pain,
a qualified health professional can determine the cause of your pain and
prescribe appropriate therapy and rehabilitation strategies specifically for
your circumstance. For more information,
visit www.nhwc.ca.
This article is a
basic summary for educational purposes only.
It is not intended, and should not be considered, as a replacement for
consultation, diagnosis or treatment by a duly licensed health practitioner.
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