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Heel Pain

What is Plantar Fasciitis?

Plantar Fasciitis is a painful inflammatory condition generally caused by overuse or over stretching of the plantar fascia. The overstretching causes multiple small tears in the plantar fascia resulting in mild swelling and inflammation. The inflammation is generally localized under the heel or arch causing pain during exercise, standing and walking. The pain is most often felt first thing in the morning, after sitting for an extended period and at the end of the day.

The condition is very common, especially in people who stand at work for long periods, stand on hard surfaces, use their feet heavily or are predisposed to the problem such as people with flat feet.

Plantar fasciitis can persist for years if the causes are not treated effectively. An experienced podiatrist at Frankston Podiatry can design a treatment program to relieve your symptoms in the short term and prevent the injury from re-occurring.

Anatomy of the Plantar Fascia:

The plantar fascia is a strong ligament on the bottom of the foot. It begins at the heel bone as one band and runs the along the entire bottom of the foot fanning out towards the toes. The plantar fascia is an actual continuation of the Achilles tendon and helps transfer the pull of the Achilles to the foot during walking.

Problems with the Plantar Fascia:

The plantar fascia acts to support the inside arch of the foot. As one walks, the plantar fascia will stretch and contract as the weight is put through the foot. The problem occurs when the ligament is under constant stress and stretch such as with flat feet or tightness of the fascia. The ligament will begin to tear off from its origin in the heel bone. After several small tears develop inflammation of the area develops leading to the name plantar fasciitis.

What is a Heel Spur and does it matter?

A heel spur is extra bone on the bottom of the heel associated with the constant over pull of the plantar fascia on the heel. When there is a pulling on a bone attachment from a ligament or a tendon, bone will respond by growing in the direction of the pull. In the case of the plantar fascia, when the ligament is tight and on a constant stretch for many months and years a bone spur can grow in the area. The bone spur itself is not painful or problematic in most cases. It is when the plantar fascia begins to tear from the area that the symptoms occur. One can have a very large heel spur and no plantar fasciitis or pain, and one can have a great deal of pain and no spur at all. The spur is simply a measure of the length of time the ligament has been short and tight.

Symptoms of Plantar Fasciitis:

The pain of plantar fasciitis is most commonly felt in the bottom of the heel towards the inside of the foot. Patients describe the pain as deep and achy and sharp at times. The main pain is with first steps after resting or not being on the foot for some time. With walking, the pain gets better and may even go away.

Plantar Fasciitis Conservative Treatment Options:

Conservative treatments will heal the plantar fasciitis 90% of the time. The initial conservative therapy will consist of a combination of ice therapy, stretching exercises to improve flexibility (especially in the mornings), and physical therapy. Most patients will also need some form of orthotic to help control the motion in the foot and the arch in order to take the strain off the plantar fascia. Patients who undergo treatment with Melbourne podiatry can expect o see an improvement in symptoms within two weeks, a full recovery usually takes approximately 2 months.