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PLANTAR FASCIITIS Every morning, as I look around the health club, I see people running, biking, participating in boot camp, step, and zumba. And when I see all this activity, it makes me realize the beating our feet take on a daily basis. In fact, a majority of the stress from physical activity is directed at the feet. Thus, good shoe gear is important. I speak from experience – something many of you may not know is that prior to medical school, I was a podiatrist. Thus, I have expertise concerning foot problems – whether they’re those seen in the Emergency Department or those I witness as a medical legal consultant. One of the most common foot complaints addressed by medical professionals is plantar fasciitis – approximately 10 percent of all athletes experience at least one case of this in their career. Ask yourself – do you have a sharp pain in your heel just as you step out of bed in the morning? Perhaps you have heel pain after participating in a rigorous class? If so, you may have plantar fasciitis. What is plantar fasciitis? This is an inflammation of the band of tissue that extends along the bottom of the foot from the heel bone (calcaneous) to the ball of the foot (metatarsal heads). This inflammation is usually due to biomedical abnormalities and stresses that are placed on the foot. Abnormal motion such as excessive pronation, whereby the foot flattens out during midstance, may be one of the leading causes for this problem. Sometimes, there may be a traumatic event wherein the plantar fascia is injured, leading to chronic inflammation. With lack of treatment, the plantar fascia is stressed and stretched with every step you take – exacerbating the problem. Thus, the abnormal forces that are the root of the problem must be controlled in order to treat the condition and diminish pain. What are the symptoms? If one has plant fasciitis, the first steps in the morning are the most painful and a person will have heel and midfoot pain. The plantar fascia contracts during sleep, so when you first awaken the muscle is being painfully stressed by immediate stretching as you first move your foot. The pain typically diminishes during the day as the muscle is stretched with normal activity. In some circumstances, people may have swelling accompany the sharp pain. How is this diagnosed and treated? Usually, a clinical diagnosis is needed based on one’s history. Physical examination will reveal pain on the inside of the heel and the arch. An x-ray may show a heel spur – indicative of a chronic problem. In order to treat the condition, abnormal stresses must be controlled in the foot. Appropriate shoe gear is essential and recommendations may come from a health care professional or a specialized shoe store. Stretching of the foot is also a good preventative measure – your personal trainer or physical therapist may assist with this. Sometimes, a trip to your orthopedic surgeon, podiatrist, or chiropractor may be in order and custom-made arch supports, called orthotics, will be prescribed. Treatment, which may last up to one year, could require a variety of health care professionals. With severe cases, a steroid injection into the heel and oral anti-inflammatory medications are prescribed. This is usually accompanied by a course of physical therapy, home exercises, and night splints. Surgery is a last resort with less than optimal results. As with most medical problems, an appropriate medical evaluation is important. Literature is available from your health care provider or on the Internet – but be certain to consult reputable sources. |
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