Prevention Of Plantar Fasciitis
There are many steps you can take to help prevent plantar fasciitis.
First, try to limit the factors that increase your risk of heel pain, Steege says:
- Maintain a healthy weight to ease the load on your heels.
- Warm up before exercise, including calf stretches.
- Increase running and other forms of high-impact exercise gradually.
- Choose shoes that support your arch and cushion your heel.
Also, if youre a runner, update your running shoes regularly. I encourage runners to change their sneakers every 300 to 400 miles, or every three to four months, whichever comes sooner, Quirolgico says. Over time, the materials in your shoes wear down, which lowers their shock absorption and increases the pressure on your plantar fascia.
Tight calf muscles can also make you prone to plantar fasciitis. One of the best things you can do to prevent plantar fasciitis is to stretch out your calves regularly, Steege says. Its especially helpful to stretch them out before and/or after exercise. If stretching before exercise, do it after warming up.
If youve had plantar fasciitis in the past, consider working with a physical therapist to find out if you have any muscle weaknesses or mobility issues that could cause a recurrence. Weakness and immobility in areas such as the hip and ankle can create changes in the foot, Steege says.
Strengthening your muscles, increasing mobility, and improving endurance can help manage conditions.
Treatment Options For Plantar Fasciitis
If you think you may be suffering from plantar fasciitis there are a few things you can try to help alleviate the pain. Start by making sure you are wearing supportive shoes, such as running shoes, as much of the time as possible. Avoid flat shoes or sandals if at all possible.
Stretching out the calf muscles can also help to reduce the stress in the fascia. You can also try taking an over-the-counter anti-inflammatory such as ibuprofen or naproxen. In addition, you may want to cut back on any activities that may be putting too much stress on your feet.
Common Heel Pain Diagnoses
While overuse tends to be the underlying cause in most cases, there are also a variety of different clinical diagnoses that can be responsible for the symptoms. It all depends on what specific part of the body has been injured, and how severe it is.
- Plantar fasciitis is the most common cause of heel pain along the underside of the heel, and is the result of a damaged plantar fascia ligament. The plantar fascia tightens up at night, so the first steps of the morning often cause sharp pain.
- Achilles tendinitis affects the back of the heel, specifically the heel cord behind the ankle. It is caused by swelling and inflammation in the tendon that connects the heel bone to the calf muscle.
- Bursitis symptoms are very similar to those of Achilles tendinitis. However, the cause of this condition is inflamed bursae, which are fluid-filled pads that cushion muscles and tendons near the heel.
- Heel spurs are bony projections that form at the front of the heel bone and point toward the arch. They may form in response to chronic plantar fasciitis, and are not always painful on their own. They can be detected via X-ray.
- Compressed nerves, also known as pinched nerves, can lead to tingling or burning pain in the heels and feet. Nerves that run through narrow tubes and tunnels in the ankle are especially vulnerable to physical pinching or obstruction.
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Conditions Related To Plantar Fasciitis
Plantar fasciitis is the most common cause of heel pain, but it is not the only one. Among these other causes of heel pain are:
Bursitis Bursas are fluid-filled sacs that cushion bones and muscles near large joints in the body. Theyre found in the hips, shoulders, and elbows, as well as places like the heel of the foot. Bursas in the foot can become inflamed and painful due to excessive walking, running, or jumping.
Calcaneal Apophysitis The growth plate, or epiphyseal plate, in the heel can become inflamed. The condition, also known as Severs disease, usually occurs in children during growth spurts.
Lateral Plantar Nerve Entrapment Nerves along the central part of the arch can become compressed between bone and tissue, resulting in pain around the heel and ankle area of the foot.
Plantar Fascia Rupture In rare cases, the plantar fascia can rupture, according to Quirolgico. This painful injury usually occurs during high-impact exercise, such as sudden jumping, running, and sprinting.
Sciatica Injury or pressure on your sciatic nerve, which controls muscles in the knees and lower legs, can cause lower-back and leg pain. The pain can sometimes be felt in the foot, but it might be more of a tingling or numbness than the pain typically associated with plantar fasciitis.
Factors Causing The Arch Pain In Mrs X
The increase in body weight was clearly a contributing factor in the onset of Mrs Xs arch pain. The weight gain adds load to the feet and causes stress and strain on muscles and tendons. When the weight gain occurs quickly, the feet dont always cope with the extra stress and the Plantar Fascia can become overloaded. This leads to the micro tearing and inflammation of the Plantar Fascial fibres.
In addition to this, the extra body weight leads to an increase in calf muscle bulk and tightness. This muscle group works harder during stance and push-off in heavier patients. The stiffness in these muscles, which are attached to the back of the heel, causes a stronger pulling action on the back of the foot. This in turn causes a stronger pull through the sole of the foot, which can lead to strain in the Plantar Fascia and result in arch pain.
Theres a fairly good case that would suggest Mrs X would not have developed this acute arch pain had she worn more supportive shoes. Ballet flats, and any shoes that are flat and flexible are likely to cause problems in heavier patients, if used for longer periods.
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How Does Plantar Fasciitis Differ From Heel Spurs
A heel spur is a bone spur, or calcium deposit, which develops toward the back of the heel bone, near where the plantar fasciitis inserts. Heel spurs commonly occur in people with tight calf muscles, just like plantar fascia does. But heel spurs dont cause heel pain the same way plantar fasciitis does.
Many people can have heel spurs without any symptoms, Dr. Latt said. So, if you have pain on the bottom of the heel, plantar fasciitis is most likely to blame.
How To Relieve Plantar Fasciitis Pain
If youre managing plantar fasciitis pain, the good news is that most cases are completely treatable through conservative care over the course of a couple of months. One of the first steps is to try resting the affected foot or feet a bit more than usual. This may mean dialing back your exercise routine or switching to some non-weight-bearing activities to give the fascia along the bottom of your foot a chance to rest. If your work keeps you on your feet, pay attention to opportunities where you can incorporate some sitting as a part of your routine. Many have also experienced relief by applying ice to the affected area.
Light stretching of the plantar fascia can also be beneficial, though you should be careful of excessive stretching of the area, as this can contribute to more tearing along the fascia. Even if your goal is to keep your feet in tip-top shape, be careful not to overdo it with too many aggressive foot stretching exercises. Additionally, some experience relief by sleeping in a foot splint or by incorporating orthotics into their footwear rotation.
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Her Arch Pain Was Due To Plantar Fasciitis
Mrs X was referred to the imaging centre for an Ultra sound scan of her painful foot. She was relieved when the report explained the cause of her arch pain, describing inflamed Plantar Fascia a condition commonly known as Plantar Fasciitis. Plantar Fasciitis can cause pain in the heel and the arch of the foot and is common in people carrying extra body weight. The Sports Podiatrist reassured Mrs X that Plantar Fasciitis was a common condition that was treatable, and that she would make a full recovery within a month or 2, once treatment commenced.
Treatment Of Mrs X Arch Pain
It was explained to Mrs X that she needed to lose weight in order to help her fatigued feet and reduce this chronic and acute arch pain. She was already aware of this and explained she cant walk for exercise, to burn the calories. She was advised to swim and perform resistance training for her upper body. Mrs X enquired about the use of prescription orthotics. She felt her feet were more unstable since gaining weight. The Sports Podiatristexplained to Mrs X that the orthotics were a valid treatment option, and that the Carbon Fibre material would be the preferred choice. These are a firm material but are streamlined and less bulky, and so fit into more shoes more easily. They would have slow release poron to provide cushioning and the support from these orthotics would reduce the strain on the whole foot, particularly the arch. This would allow the arch pain to resolve over time, as the micro tears and inflammation subsided.
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When To See Your Gp
See your GP or a podiatrist if youve had persistent heel pain for a number of weeks and it hasn’t cleared up.
They should be able to diagnose the cause of your heel pain by asking about your symptoms and medical history and examining your heel and foot.
Further tests will only usually be needed if you have additional symptoms that suggest the cause of your heel pain isn’t inflammation, such as:
- numbness or a tingling sensation in your foot, which could be a sign of nerve damage in your feet and legs
- your foot feels hot and you have a high temperature of 38°C or above, which could be a sign of a bone infection
- your heel is stiff and swollen, which could be a sign of arthritis
The Number 1 Cause Of Adult Heel Pain: Plantar Fasciitis
Plantar fasciitis is the most common source of heel pain in adults. It is caused by inflammation of the plantar fascia, the ligament that runs along the bottom of your foot and connects the toes to the heel.
The plantar fascia supports the arch of your foot and helps absorb the shock of impact when you walk or run. When you place too much tension on this tissue, it stretches and may become inflamed or even tear or rupture.
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What Is The Plantar Fascia
Your plantar fascia is located on the bottom of your feet and consists of a thick band of tissue that connects from the heel bone into your toes. When youre active, this fascia plays the vital role of a hard-working support system in your foot. The band essentially acts as a bow to help absorb shock and provide support to both of your feet throughout dynamic movement. Pretty awesome, right?
Charcot Arthropathy Of The Foot
Charcot arthropathy of the foot is a syndrome where patients with numbness of their feet, which can be caused by a variety of underlying conditions such as diabetes, develop weakening of the bones in the foot and ankle. Thus they may have fractures and dislocations of the bones and joints that occur with little trauma.
You should visit your primary care physician who will likely coordinate care with a muscle and bone specialist . Treatment usually involves a protective split, walking brace, or cast.
Top Symptoms: joint pain, constant foot swelling, pain in one foot, warm red foot swelling, swelling of both feet
Symptoms that always occur with charcot arthropathy of the foot: warm red foot swelling, constant foot swelling
Urgency: Primary care doctor
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Chronic Idiopathic Peripheral Neuropathy
Peripheral neuropathy refers to the feeling of numbness, tingling, and pins-and-needles sensation in the feet. Idiopathic means the cause is not known, and chronic means the condition is ongoing without getting better or worse.
The condition is most often found in people over age 60. Idiopathic neuropathy has no known cause.
Symptoms include uncomfortable numbness and tingling in the feet difficulty standing or walking due to pain and lack of normal sensitivity and weakness and cramping in the muscles of the feet and ankles.
Peripheral neuropathy can greatly interfere with quality of life, so a medical provider should be seen in order to treat the symptoms and reduce the discomfort.
Diagnosis is made through physical examination blood tests to rule out other conditions and neurologic and muscle studies such as electromyography.
Treatment involves over-the-counter pain relievers prescription pain relievers to manage more severe pain physical therapy and safety measures to compensate for loss of sensation in the feet and therapeutic footwear to help with balance and walking.
Top Symptoms: distal numbness, muscle aches, joint stiffness, numbness on both sides of body, loss of muscle mass
Urgency: Primary care doctor
How Plantar Fasciitis Happens
When this fascia gets overused or inflamed, it can turn into one of the most common causes of heel pain. Because of its supportive role through movement, plantar fasciitis is incredibly common amongst runners, although other physically active adults may also develop plantar fasciitis, with risks increasing for those over 40.
So what causes plantar fasciitis? When that band of fascia becomes overworked and has excessive tension and stress placed upon it repeatedly, small tears can start to form. These tears are the irritation that leads to plantar fasciitis and the feeling of stabbing heel pain. Though the pain usually subsides a bit with some warming up of the foot, it generally returns post-activity, after prolonged periods of sitting, and first thing in the morning.
Runners and athletes are not the only populations who are affected by plantar fasciitis though. Some people who are genetically a bit more flat-footed as well as those who have a higher arch than normal have experienced this same stabbing heel pain. This is a result of foot mechanics needing to work a bit harder to distribute weight evenly.
Plantar fasciitis can also develop in those engaging in repeated jumping routines through dance or exercise, have jobs that keep them on their feet throughout the day, or those who struggle with obesity.
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What Not To Do With Plantar Fasciitis
The pain and discomfort that comes with plantar fasciitis can be so frustrating that youd probably try anything to get rid of it, but Dr. Torzok wants you to know that certain remedies will only exacerbate the problem.
If you have heel pain, do not:
- Exercise your feet. You may think that running or jumping will stretch out the problem, but high impact in the feet will only make it worse. In fact, try to avoid all running, hiking and high-intensity cardio.
- Stand for long periods of time. Make modifications if you have a job that requires you to stand for hours at a time, as this only adds more pressure to plantar fasciitis.
- Wait for treatment. You may think that with a few days rest, youll be back on your feet. But the truth is, your heel pain may only subside with help from a doctor. Dont tough it out. Get to the bottom of whats causing your plantar fasciitis so that you can treat it properly.
Why Do I Have Plantar Fasciitis
Most people who suffer from plantar fasciitis don’t recall any type of acute injury. The heel pain usually starts gradually and then becomes more severe. Contributing factors to plantar fasciitis heel pain include having a low or high-arched foot, improper shoes, over-exertion, and recent weight gain.
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Achilles Tendinitis Risk Factors
Risk factors for Achilles tendinitis include:
- Gender: Men are more likely to develop Achilles tendinitis.
- Age: The Achilles tendon weakens with age, making injury more likely.
- Flat feet: Low arches place more strain on the Achilles tendon.
- Obesity: Again, being overweight puts additional strain on your body in numerous ways, particularly the weight-bearing structures of your feet and lower legs.
- Inadequate shoe support: If youre a runner, you need to replace your footwear regularly at least every 300-400 miles.
- Exercising in cold weather: Risk of Achilles tendon injury is higher in cold weather than when its warm.
- Hilly terrain: Running or walking on uneven or hilly terrain also increases the risk of injury.
- Certain medical conditions: Both high blood pressure and psoriasis increase your odds of developing Achilles tendinitis.
- Fluoroquinolones: An antibiotic prescribed to treat certain types of bacterial infections, fluoroquinolones increase your risk for tendinitis.
Symptoms Of Achilles Tendinitis
The pain of Achilles tendinitis usually starts as a mild ache just above the heel or at the back of the leg. Pain may be more severe after more prolonged or intense activity. You may also feel more tender or stiff after long periods of inactivity, with symptoms easing after you walk around for a bit.
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Symptoms Of Plantar Fasciitis
If you develop plantar fasciitis you will likely feel a sharp or stabbing pain on the bottom of the heel. Sometimes the pain extends into the arch area of the foot, but heel pain is the most common symptom of plantar fasciitis.
The pain is usually the most severe when you first get up in the morning or after youve been resting for a while. Sometimes the pain improves when the fascia gets “loosened up”, but it usually increases again if youve been on your feet too long.