What is Plantar Fasciitis?
Have you ever experienced pain that does not go away with time at the bottom of your foot? Plantar Fasciitis is often caused by over usage of the Plantar Fascia. People who engage in long distance running without wearing shoes that provide good cushioning and support are much more prone to this.
Plantar Fasciitis is a medical condition which affects the feet. It will cause extreme pain and this pain is more pronounced during the morning when the ligaments and tendons in the feet are not yet warmed up. Many patients describe the pain they experience in the morning as being stabbed repeatedly in the feet. The onset of pain is largely due to long periods of immobility of the feet such as a long day of using the computer. As the activities around the leg increases, the pain will decrease. The most common treatment method is the use of anti-inflammatory medication as well as pain killers to provide pain relief.
Plantar fasciitis is one of the most common causes of heel pain and responsible for up to 80% of cases regarding pain at the bottom of the foot. Pain usually come within the first steps of the day or after a period of rest. Generally, the pain decreases throughout the day.
It is often due to inflammation of a thick band of tissue called the plantar fascia, which runs across the bottom of the foot, connecting the heel bone to the toes. Sometimes the pain can be compounded by a tight Achilles which affects 1 in 3 people.
Plantar Fasciitis is common amongst runners, people who are overweight or if you don’t wear protective shoes. So if you do take part in marathons around Singapore, take note!
How is it Diagnosed?
The chief diagnostic sign of these problems is pain in the bottom of the heel or arch when first standing, which gradually improves with walking. This pain may later return with continued walking. The pain usually subsides after a period of rest.
Common symptoms include swelling, clicking or snapping sounds, or significant pain at the sole of your feet.
Symptoms like numbness and tingling, are rare but not unheard of as well.
What are the Causes?
Under normal circumstances, the plantar fascia acts like a shock-absorbing bowstring, supporting the arch of the foot. But when the tension on the bowstring becomes too great, it creates small tears in the fascia. Repetitive stretching and tearing causes the fascia to become irritated or inflamed.
This is especially common with runners or the obese where significant pressure is exerted on the heels which can cause Plantar Faciitis. People with abnormally high foot arches or flat feet are also more susceptible Plantar Faciitis due to how their feet roll inward when performing physical activity.
How to Prevent it?
Maintaining a healthy weight minimizes the stress on the plantar fascia and choosing supportive shoes by avoiding high heels and wearing shoes with a low to moderate heel, good arch support and shock absorbency. Do not go barefoot, especially on hard surfaces.
The effects of Plantar Faciitis can also be reduced with proper stretching, and running techniques that apply less pressure to the heel. Changing your running shoes as they get old and lose their ability to cushion your heel is important as well. Typically, you should change your shoes after about 500 miles or 800 kilometers.
If you have an abnormally high arch or flat feet, proper shoes and insoles can also prevent Plantar Faciitis or other conditions from affecting your feet.
Ice baths or other applications of ice on the affected area can also help alleviate some pain and relieve some stress on the heel. You can do this in two main ways.
The first is the ice massage, by filling a paper cup with ica and rolling it over the affected area for 5 to 7 minutes.
The second thing you can try is a cloth covered ice pack over the affected area for 15 to 20 minutes after the activity or 3-4 times a day.
What are the Treatments for Plantar Fasciitis?
About 90 percent of people who suffer from plantar fasciitis recover with conservative treatments in just a few months. Non-surgical treatment is often used from simple stretches to calf strengthening exercises or weight reduction.
Anti-inflammatory drugs may ease pain and inflammation, although they do not treat the underlying problem. Occasionally, shock wave therapy or plantar iontophoresis (shockwave therapy with anti-inflammatory substances) is used as a form of treatment for Plantar fasciitis if the patient is unresponsive to initial treatment.
Another potential solution is a cortisone injection, a steroid that helps relieve inflammation and pain in the foot. Administration of cortisone should be controlled by your doctor to prevent overdosing which causes chronic pain and cause your plantar fascia to tear.
Physical therapy or learning how to do simple calf and foot stretches can also be very useful in treating Plantar Fasciitis. Patients that are unresponsive to the treatment after a year may also be recommended to undertake Gastrocnemius recession, a surgical procedure to lengthen the calf muscles to reduce stress.
Ignoring Plantar Faciitis can cause prolonged pain the the heels, and lead to compounding problems in the back, feet, knees and hips.
Consider These Home Remedies for Plantar Fasciitis
Plantar Fasciitis is a troublesome and painful leg condition that will cause a lot of discomfort throughout the day and night. It is not good to depend on pain relief medication always and whenever possible, you should substitute the pain relief medication with some home remedies.
The first and foremost is to stop whatever is causing the pain and this is usually running. You need to provide sufficient time for the inflammation in the fascia to go away and this can reduce the pain significantly. During this period, you should not engage in any form of sporting activities.
The next step would be to apply ice pack on the painful area. Ice pack will help to reduce the swelling, decrease the pain and help to control inflammation. Make sure that you are applying ice pack and not a warm pack as you should only apply a warm pack before any activities and not after.
Ice is probably the cheapest and one of the most effective home remedies. If you have an ice pack, use it. If not, you can even use frozen peas. Massage the painful area for around 15 minutes, 5 times a day. Ice can help to bring down swelling and reduce inflammation.
Plantar fasciitis taping or simply taping can help to relieve stress and pressure on the plantar fascia ligament as it inhibits movement of the fascia. It can be easily done with athletic tape which is widely available in sporting stores.
Anti-inflammatory medication such as ibuprofen or aspirin can help to reduce inflammatory and reduce pain. If over the counter medication do not help, you may consider getting prescribed medication to relieve the pain.
Shock Absorbing Heel Pads
Heel pads with shock absorbing features are excellent in treating plantar fasciitis. They help to cushion whatever shock that is experienced during walking and running. Heel pads can also help to reduce arch strain which is usually associated with plantar fasciitis.
Protective Arch Support Insoles
You should purchase insoles that provide arch support and place them in your shoes. It can help to reduce pain and divert away some of the impact to bring relief of pain when you move around. If possible, you should even wear them at home when you move around.
Night Splint / Foot Splint
When you turn in for the day, you should use foot splints to brace the foot, ankle and lower leg. The main purpose of the splint is to provide gradual stretches of the plantar fascia throughout the night, reducing stress levels and reducing pain and inflammation. Since the stretching continues through the night, you will experience lesser pain when you first wake up in the morning.
In other words.. during night time, the plantar fascia muscle will contract and tighten, resulting in tremendous pain when you wake up in the morning. The pain will slowly decrease as the day passes as the muscles are stretched. Therefore, wearing a night splint during sleep will prevent the plantar fascia muscle from contracting and tightening, reducing the pain experienced when you wake up in the morning.
Massages Using Creams or Oils
If able, you should massage the painful area with pain relief creams or even medicated oils multiple times during the day. Massages with medicated oils will help increase the blood circulation level at the legs and bring pain relief and promote healing.
6 Effective Plantar Fasciitis Exercises for Heel Pain
Generally, stretching exercises can help to reduce the pain significantly in a short period of time. Stretching will also increase the flexibility of the ligaments and increase the muscular strength, allowing it to better support the arch of the foot. Whenever possible during the day, you should perform stretching exercises targeted at your legs. Exercises that stretch the Achilles tendon and Plantar Fascia will help to increase flexibility and warm the area up, reducing pain.
Here are some simple exercises you can perform:
Often people who suffer from plantar fasciitis experiences intense heel pain in the morning when they wake up, and taking the first steps of the day is a painful process to undergo. This is due to the tightening of the plantar fascia during sleep. Stretching the plantar fascia before standing up can have significant results and often reduces the heel pain.
Stretch the foot by flexing it up and down 20 times before standing. Use a towel and pull the heel towards you, stretching the bottom of the foot.
Stand 6 to 8 meters away from a wall and lean towards it while keeping the knees straight and heel firmly flat on the ground at all times. There will be a slight strain on the calf muscles and you can feel your Achilles tendon starting to tighten up. Holding this position for 15 seconds, repeat it 10 times each set, doing it throughout the day. Thru this exercise, the Achilles tendon and calf muscles can be stronger and much more flexible.
Place marbles and a cup on the floor. Using only the toes, lift the marbles up one by one and place them into the cup. Repeat the exercise for 10 times, 3 sets each time. This not only stretches the muscles, it also improves the coordination skills of you.
Place your left leg infront of you and keep it flexed. As you bend your right knee, lean back slightly. You should notice your pelvis tilted forward. Keep the upper body straight and hold the position for 15 seconds, then switch sides. You should be able to feel a strain all the way up the back of the extended leg.
Standing on the floor barefooted, raise your heels up slowly while using the balls of your feet and toes. Hold the position for 5 seconds and slowly go down again. Repeat this exercise 10 times, 5 sets each.
Either with or without shoes, move your foot around your ankle drawing a big circle with your big toe in the air. Do it both clockwise and anticlockwise and repeat as many times as you like.
There is no one single treatment for plantar fasciitis. Rather, it is a combination of a number of methods all joined together for optimal results. It is important to keep the muscle warm and flexible to reduce the pain.
At the Singapore Sports and Orthopaedic Clinic, our orthopaedic specialists are ready to help you get back to the activities you know and love. Call us today for an appointment @ +65 9734 3087 to get a professional assessment of your condition & start your journey toward a better life!