Plantar fasciosis is pain at the site of the attachment of the plantar fascia and the calcaneus (calcaneal enthesopathy), with or without accompanying pain along the medial band of the plantar
fascia. Diagnosis is mainly clinical. Treatment involves calf muscle and plantar soft-tissue foot-stretching exercises, night splints, orthotics, and shoes with appropriate heel elevation. Syndromes
of pain in the plantar fascia have been called plantar fasciitis; however, because there is usually no inflammation, plantar fasciosis is more correct. Other terms used include calcaneal enthesopathy
pain or calcaneal spur syndrome; however, there may be no bone spurs on the calcaneus. Plantar fasciosis may involve acute or chronic stretching, tearing, and degeneration of the fascia at its
Plantar fasciitis can develop when your feet roll in too far as you take each step. This rolling in, known as over-pronation, can happen for many reasons. It can be due to excessive weight gain,
pregnancy, quickly increasing physical activity, tight calf muscles, poor biomechanics or merely wearing unsupportive, flat footwear. When your feet over-pronate, your arches can collapse, putting
strain on the tissues in the bottom of your foot.
People with this condition sometimes describe the feeling as a hot, sharp sensation in the heel. You usually notice the pain first thing in the morning when you stand. After walking for a period of
time, the pain usually lessens or even disappears. However, sharp pain in the center of the heel may return after resting for a period of time and then resuming activity.
Physical examination is the best way to determine if you have plantar fasciitis. Your doctor examines the affected area to determine if plantar fasciitis is the cause of your pain. The doctor may
also examine you while you are sitting, standing, and walking. It is important to discuss your daily routine with your doctor. An occupation in which you stand for long periods of time may cause
plantar fasciitis. An X-ray may reveal a heel spur. The actual heel spur is not painful. The presence of a heel spur suggests that the plantar fascia has been pulled and stretched excessively for a
long period of time, sometimes months or years. If you have plantar fasciitis, you may or may not have a heel spur. Even if your plantar fasciitis becomes less bothersome, the heel spur will
Non Surgical Treatment
The following self-help treatments have been found to be most effective. Rest your foot. Reduce the amount of weight-bearing activities you participate in. Get off of your feet and elevate them. This
will allow healing to begin. Apply ice to your foot. Applications of ice packs that provide a comfortable cooling to the heel and arch (not a freezing cold) will help reduce pain, swelling, and
inflammation. Apply the ice to the heel and arch (not the toes). Make sure it is comfortable, and leave on your foot for about 20 minutes, 3 times a day. If you have any medical problems such as
diabetes, poor circulation, etc., discuss the use of ice with your doctor before applying the ice. ActiveWrap allows you to apply comfortable cold therapy to your foot without messy ice cubes. Use
while on the "go." Do not walk with bare feet. Always protect your heels, arches, and plantar fascia with good supportive shoes. Orthaheel Orthotic Flip Flops For Men and Women are designed for
walking comfort with built in orthotic footbeds that help reduce foot pain from plantar fasciitis. Use in the house or on the beach. Stretch the Plantar Fascia while sleeping. Plantar Fasciitis and
Heel Spur pain is usually worse with the first steps in the morning. This is due to the Plantar Fascia tightening up, or contracting while we sleep. To prevent these pain producing contractures of
the plantar fascia, the foot must be held in its normal or neutral position while we sleep. This optimal position of the foot is maintained with our comfortable and supportive Night Splint. When foot
contractures are prevented during sleep, the "first step pains" Plantar Fasciitis and Heel Spurs will gradually subside. Stretch the Plantar Fascia during the day. Even though the Plantar Fascia is a
thick tissue band with very little "give" to it, with the proper care (a Night Splint and the following exercises) it can be stretched a small amount. By stretching the Plantar Fascia even a bit, its
abnormal pull on the heel is reduced. This will help to reduce pain and inflammation in the heel and arch. Two of the most effective exercises recommended are. Before stepping down, especially after
sleeping or resting, stretch the arch of the foot by stretching your legs out in front of you (do not bend the knee). Place a towel around the ball of the foot. Slowly pull on the ends of the towel,
pulling the toes and ball of the foot back as far as is comfortable. Hold the foot in this position for ten seconds. Repeat at least ten times. You should feel a pull on the bottom of the foot,
especially in the arch. This stretches the plantar fascia, and reduces its pull on the heel. Stand about 2 to 3 feet from a wall. Lean forward with your hands against the wall. With the painful foot
behind, place the other foot forward. Press against the wall, shifting weight over the front foot, while straightening the back leg. Keep the heel of the back foot on the floor and feel the stretch
in the heel, Achilles tendon, and calf. Hold this position for ten seconds. Repeat at least ten times, and try to do this three times a day. When these things are achieved, the inflammation and pain
of Plantar Fasciitis and Heel Spurs will gradually subside. If you are unsure of the nature of your foot problem, if your pain is intense and does not subside, if you are a diabetic or have other
medical problems, if your pain is due to an injury, if an open sore is present, if a mass can be felt, or if you think that you may have an infection, we suggest that before beginning any of the
above treatments you consult with your doctor.
In very rare cases plantar fascia surgery is suggested, as a last resort. In this case the surgeon makes an incision into the ligament, partially cutting the plantar fascia to release it. If a heel
spur is present, the surgeon will remove it. Plantar Fasciitis surgery should always be considered the last resort when all the conventional treatment methods have failed to succeed. Endoscopic
plantar fasciotomy (EPF) is a form of surgery whereby two incisions are made around the heel and the ligament is being detached from the heel bone allowing the new ligament to develop in the same
place. In some cases the surgeon may decide to remove the heel spur itself, if present. Just like any type of surgery, Plantar Fascia surgery comes with certain risks and side effects. For example,
the arch of the foot may drop and become weak. Wearing an arch support after surgery is therefore recommended. Heel spur surgeries may also do some damage to veins and arteries of your foot that
allow blood supply in the area. This will increase the time of recovery.
In one exercise, you lean forward against a wall with one knee straight and heel on the ground. Your other knee is bent. Your heel cord and foot arch stretch as you lean. Hold for 10 seconds, relax
and straighten up. Repeat 20 times for each sore heel. It is important to keep the knee fully extended on the side being stretched. In another exercise, you lean forward onto a countertop, spreading
your feet apart with one foot in front of the other. Flex your knees and squat down, keeping your heels on the ground as long as possible. Your heel cords and foot arches will stretch as the heels
come up in the stretch. Hold for 10 seconds, relax and straighten up. Repeat 20 times. About 90 percent of people with plantar fasciitis improve significantly after two months of initial treatment.
You may be advised to use shoes with shock-absorbing soles or fitted with an off-the-shelf shoe insert device like a rubber heel pad. Your foot may be taped into a specific position. If your plantar
fasciitis continues after a few months of conservative treatment, your doctor may inject your heel with steroidal anti-inflammatory medication. If you still have symptoms, you may need to wear a
walking cast for two to three weeks or a positional splint when you sleep. In a few cases, surgery is needed for chronically contracted tissue.