McGovern Physical Therapy Associates - The Personal Care Professionals

PLANTAR FASCIITIS

What is Plantar Fasciitis?
When your first few steps out of bed in the morning cause severe pain in the heel of your foot, you may have plantar fasciitis. Plantar fasciitis is an overuse injury affecting the sole, or flexor surface (plantar) ligament, of the foot. A diagnosis of plantar fasciitis means you have inflamed the tough, fibrous band of tissue (fascia) connecting your heel bone, through your arch, to the base of your toes.

You are more likely to get the condition if you are a woman, if you are overweight or if you have a job that requires a lot of walking or standing on hard surfaces. You are also at risk if you walk or run for exercise, especially if you have tight calf muscles that limit how far you can flex your ankles. People with very flat feet or very high arches are also more prone to plantar fasciitis.

If you do not treat plantar fasciitis, it may become a chronic condition. You may not be able to keep up your level of activity, and you may also develop symptoms of foot, knee, hip and back problems because of the way plantar fasciitis can change the way you walk.

What are the symptoms of Plantar Fasciitis?
Symptoms of plantar fasciitis can occur suddenly or gradually. When they occur suddenly, there is often intense heel pain on taking the first morning steps. This heel pain will often subside as you begin to walk around, but it may return later in the day. This first-step pain is also felt after sitting for prolonged periods of time.
When symptoms occur gradually, a more long-lasting form of heel pain will cause you to shorten your stride while running or walking. You also may shift your weight toward the front of the foot, away from the heel.
The pain from plantar fasciitis can be described as being dull, aching or sharp and can usually be reproduced by flexing the toes upwards (dorsiflexion) and tensing the fascia.

What are the causes of Plantar Fasciitis?
Several biomechanical factors cause plantar fasciitis, such as abnormal inward twisting of the foot (pronation), high arches, flat feet or tight tendons along the back of the heel (Achilles tendons). Excessive pronation has been found in about 85% of those who suffer from plantar fasciitis. Prontion can be responsible for added tension in the plantar fascia as the arch lowers during standing or walking. Also, repetitive pressure on the feet, such as from jobs or activities that require prolonged walking or standing on hard or irregular surfaces, may contribute. Running can also lead to wear and tear on the plantar fascia as well as increased intensity in training or exercise pattern. Aggravating factors, such as being overweight or having poorly cushioned shoes, the natural process of aging, which may cause tissue in the heels to weaken over time, may also be causes. In rare cases, a single, traumatic injury to the foot such as from a motor vehicle accident can cause the onset of plantar fasciitis.

How is Plantar Fasciitis treated?
Symptoms usually resolve more quickly when the time between the onset of symptoms and the beginning of treatment is as short as possible. Most doctors recommend an initial six- to eight-week program of conservative treatment. This usually requires rest, the use of ice after activities, and stretching.

A licensed physical therapist can develop a supervised exercise program to stretch the plantar fascia and Achilles tendon and to strengthen the lower leg muscles, which stabilize your ankles and heels. These include exercises for flexibility, stability, balance, strength, coordination and restoration of range of motion. Electrical stimulation, ultrasound therapy, mobilization and heat or cold may also be used. These tools allow the physical therapist to create a program of rehabilitation that is custom-designed for your particular problem.

Shoe inserts called orthotics, which should be custom-molded to your feet, may also be recommended to help distribute pressure to your feet more evenly. Your feet are the foundation of your body. They support you when you stand, walk or run. And they help protect your spine, bones, and soft tissues from damaging stress as you move around. Your feet perform better when all their muscles, arches, and bones are in their ideal stable positions. The foot is constructed with three arches which, when properly maintained, give exceptional supportive strength. These three arches form a supporting vault that distributes the weight of the entire body. If there is compromise of one arch in the foot, the other arches must compensate and are subject to additional stresses, which usually lead to further compromise. By stabilizing and balancing your feet, orthotics enhance your body’s performance and efficiency, reduce pain, and contribute to your total body wellness.

Please feel free to call or come by a McGovern Physical Therapy Associate’s clinic to ask questions about your feet and if custom-made orthotics are right for you. 

McGovern Physical Therapy Associates, the personal care professionals, is a multi-specialty provider of outpatient physical therapy care located in Revere, Malden and Beverly, MA. Voted “Best PT Practice 2004” by ADVANCE for Directors in Rehabilitation magazine, our clinicians offer personalized manual therapy and exercise expertise, including a variety of customized treatment options. Combining innovation, experience and excellence, our staff of clinicians, as well as dedicated office personnel, works as a team to provide caring, convenient and professional service for total patient recovery.

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