Jamila Rawlings Logan, MSPT
It started with that morning when you awakened from your sleep to walk to the restroom. The pain in your foot was dull or sharp but definitely not how you felt the day before. As you continued to get ready for the morning, you noticed the pain in your foot was much less intense or non-existent and proceeded with your day. Later in the day you noticed that your foot hurt again getting up to walk after sitting for a long period. Now it seems that this pattern of pain is happening daily and you may have allowed this pain to go on untreated for months. Finally, you have had enough and decide to see your doctor or the physical therapist and they have told you that you are suffering with a common foot condition called Plantar Fasciitis.
Plantar fasciitis is a condition of repetitive injury to the plantar fascia of the foot. You may feel the pain in the center of the heel or close to the arch on the bottom of your foot with touch and with walking. The plantar fascia is a thick fibrous band of tissue or ligament on the bottom of the foot that spans from the heel (calcaneus bone), crosses over the arch, and attaches to the base of the bones of the toes. The plantar fascia works to give support to the arch of the foot and absorb the shock, dampening the compressive force of the ground with the foot, during the activities of standing, walking, and running. When the foot experiences excessive pressure repetitively, it leads to the inflammation and deterioration of the plantar fascia causing pain. The true depth of plantar fasciitis is complex but the common causes of this condition are being overweight, occupations that require a lot of standing or walking, having high arches or flat arches, and running. It is most prevalent in active men and women between the ages of 40 and 70.
Improving the symptoms of plantar fasciitis can be remedied in various ways. One of the best ways to improve as well as prevent symptoms is to stretch the plantar fascia, calf muscles, and achilles tendon as soon as possible. Your doctor may prescribe an anti-inflammatory medication such as Advil, Motrin, or Ibuprofen that will work with your body to reduce the inflammation of the plantar fascia as well as reduce your pain. The medicine alone will not change the underlying damage to the fascia. It is important that you rest and decrease the stress to which the plantar fascia is subjected as much as possible. Another option for treating plantar fasciitis is to wear a night splint that maintains the foot in a dorsiflexed (toes toward the shin) while you sleep and reduces the pain with your first steps in the morning. Don’t forget to stretch after removing the splint! Along with these options, you should consider purchasing or being fitted for foot orthotics. Orthotics are used to support the arch of the foot and reduce excess stress and strain to the bones, tendons, ligaments, and muscles of the foot and ankle. Last but not least, is using ice therapy to the affected area. Using ice directly to the area or a frozen water bottle to roll the foot over is a great way to reduce the pain.
For some, home treatment and even the doctor prescribed medicine alone may not relieve your now chronic foot pain. The longer the symptoms go untreated or successfully managed, the pain can increase making standing and walking extremely challenging. This pain can then lead to pain in other areas such as the opposite foot, the Achilles tendon, the ankle (s), the knees, and the back. Physical therapy is one of the best ways to treat plantar fasciitis. Your physical therapist (PT) will prescribe stretches, a strengthening program for the muscles of the foot and ankle, work to improve your (gait) walking mechanics, and other pain reducing treatments to get you on the road to recovery. Sometimes, your PT will work simultaneously with your medical doctor’s prescribed anti-inflammatory regimen. The key to treating plantar fasciitis is PERSISTENCE!