Doctor’s offices see over one million patients per year in the United States due to foot pain. Most of those complaints are diagnosed as plantar fasciitis. Now this may sound harmless, but to a very large population it can be painful and often times debilitating. The cause for plantar fasciitis is not completely understood, but some factors may include small tears to the tendon that runs from the heel to the big toe, degenerative changes from wear and tear, bone spurs, lack of ankle and/or big toe mobility, and often times, poor intrinsic muscular strength and control. There may be pain in the ball of the foot but this is less common.
A person who may complain of foot problems and pain or plantar fasciitis may exhibit signs such as pain with the first few steps when they wake up in the morning. General pain at the heel or the inside arch of the foot. The reason for this is because the covers and blankets we use at night may keep our feet plantar flexed, meaning toes pointing down. This shortens the length of the tissues such as the calf muscles and the plantar fascia itself. Foot pain may resolve after those first several steps in the morning but may return with prolonged standing and walking.
A person who has above normal height of the arch or even flat feet may develop plantar fasciitis as well. The plantar fascia plays a very important and specific role in the Windlass Mechanism in the bottom of the foot. This mechanism helps add rigidity to the arch of the foot while plantar flexing and the big toe is pointed up. The purpose is to provide a stable foot while pushing off while walking or running. Poor ankle and big toe mobility are other factors that can cause plantar fasciitis as well as the surfaces we run/walk on, shoes, and training regimen.
The bottom of my foot is sore and painful when I get out of bed is the most common complaint with plantar fasciitis. The reason why this occurs is due to the foot relaxed position when sleeping. This causes the plantar fascia to stay in a shortened position. When you first step down on it in the morning it is stretched back out when you step down on it. This initial soreness or pain is the classic symptom of plantar fasciitis.
The plantar fascia can also be prone to a rupture or a complete tear. This is usually a single event when trauma occurs to the fascia itself. In my experience the athlete or patient will describe a popping sensation at the bottom of their foot. They also describe an immediate pain and the inability to walk. The mechanism of this injury can be a fall from a ladder or roof or during sport activities of tennis, basketball and track and field. Runners can also rupture the plantar fascia but usually this is related to a gradual weakening of the fascia over time due to repetitive stresses.
Diagnosing plantar fasciitis can be as simple as eliciting pain at the insertion or along the tissue itself through palpation. Sometime even just the classical descriptive signs and symptoms. Often times the patient may need an x-ray to check for spurring at the heel that may be causing the pain. An ultrasound that can determine a thickening of the plantar fascia or possible heel or fat pad bruises. Orthopedic surgeons will take a complete history and do a physical exam of the entire foot and ankle. At times, other diagnostic tests such as an MRI are used to confirm the diagnosis.
There are a lot of home remedies and heel pain treatments out there. Not every plantar fascia treatment may work for each individual case. The key is to find what the main cause of your pain is and find what works for you.
The recovery time or healing time for a torn or ruptured plantar fascia will vary based on the severity of the tear.
To learn more about orthotics and plantar fasciitis, please go to: Foot. If you would like to learn more about another lower leg issue, go to What Are Shin Splints?, Treating Heel Pain or Foot Arch Pain.
To schedule an appointment for physical therapy at one of the 12 JOI Rehab Centers, please call 904-858-7045.
To schedule an appointment with an Orthopedic Foot and Ankle Specialist, please call 904-JOI-2000, schedule Online or Click on the link below.