PLANTAR FASCIITIS

Plantar fasciitis is an overuse injury to the fibrous, soft band of tissue which contributes to the arch of the foot. Those suffering from plantar fasciitis usually experience pain immediately upon weight bearing in the morning. During sleep, the ankle naturally extends, shortening the plantar fascia. Upon standing, the shortened tissue suffers further microtears, but after walking 10-20 steps, the fascia lengthens and pain subsides. Most athletes suffering from plantar fasciitis are pain free most of the day and only become frustrated with the morning pain. Unless the cycle of tearing, healing and re-tearing is broken, the injury will not go away. X-rays often show a bone spur formed from the pulling of the fascia from the heel bone, but it is not the bone spur which causes the pain, it is the over-stretching or tearing of the plantar fascia.

Before bearing weight in the morning, warm up and stretch the plantar fascia by performing 10 circles clockwise and 10 circles counterclockwise, followed by 2-3 towel stretches for 15-20 seconds both with the knee straight and bent (see link below). Have a pair of shoes with a good arch support on the floor to step into and avoid walking in bare or stocking feet at all times. Sports sandals with arch supports are available at most shoe stores and help in summer months. The stretching exercises should be performed not just first thing in the morning but after prolonged periods of sitting.

Non-steroidal medications may be beneficial but should not be used prior to activity as they will mask the pain. Sports participation can be pursued as tolerated but when symptoms interfere with daily activities, consider a switch to a cross training activity (biking, swimming, elliptical trainer, etc.) until symptoms are resolved. Gradually incorporate the preferred activity until able to make a full return. Athletes may need to avoid any uphill training as this will aggravate symptoms.

Always warm up well before more intense exercise. After activity, stretch on a slant board for 20-30 seconds followed by ten minutes of ice massage. An excellent way to ice massage the arch is to keep frozen bottles of water in the freezer and roll the arch up and down on the bottle for ten minutes (see link below).

Athletes may benefit from shoe inserts, prescription anti-inflammatory medication and formal physical therapy. In severe cases, steroid injection and possibly surgery may be necessary. Research regarding shock wave therapy is mixed and not used routinely.