What is Plantar Fasciitis?

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.