PLANTAR FASCIITIS | PLANTAR FASCIITIS |

PLANTAR FASCIITIS | PLANTAR FASCIITIS |

PLANTAR FASCIITIS

Plantar fasciitis is one of the most common causes of heel pain, affecting people of all ages and activity levels. It occurs when the thick band of tissue that supports the arch of your foot—the plantar fascia—becomes inflamed or irritated. This condition often leads to sharp, stabbing pain, especially with the first steps in the morning or after long periods of rest.

At Anaheim Hills Podiatry Group, we understand how frustrating and limiting heel pain can be. Whether you're a runner, a busy professional, or simply someone who enjoys staying active, plantar fasciitis can significantly impact your daily life. The good news is, with the right diagnosis and treatment plan, most people recover without the need for surgery.

SYMPTOMS

  1. Sharp Heel Pain

  • Most noticeable with your first steps in the morning or after sitting for long periods.

  • Pain often decreases as you move around but can return after prolonged standing or walking.

    2. Stabbing or Burning Sensation

  • Usually felt in the bottom of the heel or along the arch of the foot.

    3. Pain After Exercise (Not During)

  • Discomfort often worsens after physical activity, not during the workout itself.

    4. Tightness or Stiffness in the Foot

  • Especially in the morning or after long rest periods.

    5. Tenderness to Touch

  • Pressing on the heel may reproduce or increase the pain.

    6. Mild Swelling or Warmth

  • In some cases, the heel may appear slightly swollen or feel warm to the touch.

CAUSES

⚠️ Causes of Plantar Fasciitis

  • Overuse or excessive strain on the plantar fascia

  • Repetitive impact from activities like running, dancing, or jumping

  • Prolonged standing or walking, especially on hard surfaces

  • Improper foot mechanics (e.g., flat feet, high arches)

  • Wearing unsupportive footwear

  • Tight calf muscles or Achilles tendons

RISK FACTORS

🔎 Risk Factors for Plantar Fasciitis

  • Age (most common between ages 40–60)

  • Obesity or sudden weight gain

  • Occupations that require long hours on your feet (e.g., teachers, factory workers)

  • High-impact sports or activities

  • Poor foot support or worn-out shoes

  • Limited ankle flexibility or weak foot muscles

  • History of foot or ankle issues

DIAGNOSIS & TESTS

Clinical Evaluation:

  • Review of medical history and symptoms

  • Physical exam of the foot (checking for tenderness at the heel and arch)

  • Observation of gait, foot structure, and flexibility

Imaging Tests (if needed):

  • X-ray – to rule out bone spurs or fractures

  • MRI – to evaluate soft tissues and confirm plantar fascia inflammation

  • Ultrasound – to visualize thickening or tears in the plantar fascia

WINDLASS TEST

MANAGEMENT & TREATMENT

A. CONSERVATIVE CARE

  • To reduce inflammation

1. Rest and Activity Modification

  • Rest doesn’t mean complete inactivity, it means giving your arch a break. Avoid high-impact activities, going barefoot, or wearing overly flexible shoes. Instead, opt for low-impact exercises and supportive footwear to reduce strain on the plantar fascia while staying active.

2. Compression

  • Compression socks or sleeves provide gentle pressure and support to the arch, helping reduce strain on the plantar fascia during both activity and rest. They also promote circulation, minimize swelling, and help alleviate pain in the affected area.

3. Icing

  • Apply cold therapy to reduce inflammation and relieve pain. A helpful method is rolling a frozen water bottle under the arch of the foot for 10–15 minutes, 3–4 times daily. This combines both icing and gentle massage for added relief.

4. NSAIDs (Non-Steroidal Anti-Inflammatory Drugs):

  • Medications like ibuprofen, Celebrex, Mobic, Motrin, Aleve, and Advil can help reduce pain and inflammation associated with plantar fasciitis.

    Topical NSAIDs, such as Voltaren Gel (diclofenac), may also be used for more localized relief with potentially fewer systemic side effects.

A. CONSERVATIVE CARE:

  • To improve stability

1. Footwear

  • Check list of my favorite stability shoes below. These are designed to help minimize stress on the plantar fascia by controlling excessive pronation. By providing proper support and alignment, stability shoes allow your foot to function more efficiently, reducing abnormal strain that can lead to pain and inflammation.

2. Stretching/Strengthening Exercises

Regular stretching helps relieve tension in the plantar fascia, Achilles tendon, and calf muscles, which can improve flexibility and reduce pain.

Examples:

  • Plantar Fascia Stretch: Sit down and cross one leg over the other. Using your hand, gently pull your toes back toward your shin. Hold for 15–30 seconds.

  • Calf Stretch Against a Wall: Stand facing a wall with both hands pressed against it. Step one foot back, keeping the heel flat on the ground and the leg straight. Lean forward slightly to stretch the calf. Hold for 15–30 seconds.

3. Custom molded orthotics:

  • If you have exhausted conservative measures as described above, you may need additional stability in the form of a custom molded orthotic. Similar to a stability shoe, a custom molded orthotic with improve foot function by reducing excessive pronation and stress on the plantar fascia.

4. Taping

  • Taping improves stability in plantar fasciitis by supporting the arch and limiting excessive foot movements, which helps maintain proper alignment and mechanics during activities. Although tape does not last forever it can simulate how your foot will function with improved stability from a shoe, brace or custom orthotic.

5. Physical Therapy Modalities:

  • Manual therapy, taping techniques, or stretching programs to improve alignment and flexibility.

C. SURGICAL INTERVENTION:

B. MEDICAL INTERVENTIONS:

1. Steroid Injections:

  • Corticosteroid injections may be used to provide short-term relief in cases of severe pain. However, repeated use is discouraged as it can weaken the plantar fascia and increase the risk of rupture.

2. Night Splints:

  • Keeps the foot and toes dorsiflexed to stretch the fascia overnight.

  • Fasciotomy: A surgical procedure involving the partial release of the plantar fascia, typically reserved for chronic cases that do not respond to conservative treatments.

  • Post-surgical recovery may take several months.

PREVENTION

Daily Stretching: Maintain flexibility in the fascia and Achilles tendon.

Wearing the Right Shoes: Use supportive footwear with shock-absorbing soles.

Gradual Activity Changes: Avoid sudden increases in exercise intensity or duration.

Strengthening Exercises: Build stability in the foot and ankle.

Maintain Healthy Weight: Reduces the stress placed on your feet.

PROGNOSIS

Short-Term Prognosis

Acute phase (first few weeks to months): Initial treatment focuses on reducing pain and inflammation. This includes rest, stretching exercises, icing, orthotics, and over-the-counter medications like NSAIDs. Many patients see improvement in symptoms within 6–12 weeks.

Mid-Term Prognosis

3–6 months: With ongoing conservative treatment, most patients experience substantial relief. Adherence to physical therapy, proper footwear, and activity modifications are key to recovery.

Long-Term Prognosis

After 6 months: Approximately 90% of patients recover fully without requiring surgical intervention. Persistent cases may benefit from advanced treatments like corticosteroid injections, shockwave therapy, or platelet-rich plasma (PRP).

Chronic or Refractory Cases

If symptoms persist beyond a year despite conservative measures, additional interventions (e.g., surgery or minimally invasive procedures) may be considered. These cases are less common and may have contributing factors such as severe foot biomechanics, obesity, or occupational strain

MY FAVORITE STABILITY SHOES

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SHOE ARTICLES:

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Plantar fasciitis is a manageable condition that responds well to early intervention and a multifaceted treatment approach. By addressing risk factors, adopting preventative measures, and staying consistent with recommended therapies, individuals can achieve significant pain relief and regain full mobility. For persistent or severe cases, consult a podiatrist to explore advanced treatment options and develop a personalized care plan. With proper management, most people can return to their regular activities and maintain long-term foot health.