WHAT IS PLANTAR FASCIITIS?

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2 WHAT IS PLANTAR FASCIITIS? If you're finding when you climb out of bed each morning that your first couple steps cause your foot and heel to hurt, this might be a sign of plantar fasciitis. A common condition that causes pain in the heel is known as "Plantar Fasciitis". The plantar fascia is a fascial band that attaches to the toes and heel, and extends along the arch of your foot. If your plantar fascia is irritated, it can get inflamed and can become painful when you walk or stand. Although this condition is more common in older adults, people who are younger can also develop it if they are always on their feet, such as soldiers, nurses, teachers, or athletes. This condition occurs when you strain the arch supporting fascial an d it can result in small tears to your fascial if you are repeatedly straining it which leads to swelling and pain. It occurs in one or both feet. Many individuals with plantar fasciitis experience pain with their first few steps after sitting for too long or just getting out of bed in the morning. After a few steps, the pain and stiffness seems to lessen, however the pain can increase as you go about your day, especially if you are standing for some time or have to climb stairs.

3 WHO IS AT RISK? Age Age plays a factor. Elderly people are at a higher risk for suffering with foot issues which can impair their function and balance. Your feet begin to get wider and flatten as you get older. The sole of your foot has fat padding on it which wears down and the skin on your feet gets dry as you age. When the elderly start to experience foot pain, it could be a first sign of conditions that come with age such as diabetes, arthritis, or circulatory disease. Gender Your gender can increase your risk. Women who are pregnant or wear high heels have a higher risk of developing plantar fasciitis. Older women suffer often suffer with general disability because of serious foot pain. Job-Related Each year, there are approximately 120,000 foot injuries that are jobrelated, reports The New York Times. Repeated use of your feet such as standing for long hours have been linked to plantar fasciitis along with various other foot problems. Weight Gain You add stress on your feet when you gain weight with can lead to injuries in the feet or ankles. The likelihood of the plantar fasciitis condition is increased in overweight or obese people because of the added pressure on their joints and soft tissues. "Factory workers, teachers and others who spend most of their work hours walking or standing on hard surfaces can damage their plantar fascia." -

4 HOW COMMON IS IT? The most common cause of bottom of heel pain is plantar fasciitis. In fact, each year, there is an estimate of around 2 million people who get treatment for this condition, according to the American Academy of Orthopedic Surgeons. Causes The exact cause of plantar fasciitis is not completely understood, however, repeatedly tearing the plantar fascia can cause its development. While walking, each time your foot lands on the ground, you stretch your plantar fascia, however, if this motion is repeated, it can cause strain on this ligament, and it can become swollen, inflamed, and weak, leading to pain. Activities and conditions that can cause plantar fasciitis include: High arches, tight calf muscles, flat feet, unusual rolling or twisting of the foot. Standing for long periods of time or on hard surfaces, prolonged walking, athletics, running, and other repetitive activities. Poorly cushioned or worn out shoes, being overweight, or other things that add pressure or stress to the feet. Aging. "Are you an athlete or a member of the military? Some athletes, especially runners, are more likely to get plantar fasciitis." -

5 PREVENTION SYMPTOMS When standing or walking, relax your lower legs, particularly your calves and ankles. You pull on the plantar tendon when your glutes or legs are holding tension while moving. When you are walking, rather than heel striking, try to land on the middle of your foot instead. You impact your heels less and it relaxes your plantar tendon. When you run or walk, lead with your upper body with legs following instead of using your legs to pull yourself forward. If you are running, each time you land, have your feet align under your center of mass, keeping your strides short. Other tips to prevent plantar fasciitis include: When possible, run or walk on flat surfaces. Avoid uneven surfaces like trails or hills. Use the elevator instead of the stairs. Enjoy a deep foot massage. Keep a healthy weight. Symptoms of plantar fasciitis are quite typical in most individuals. Individuals who have plantar fasciitis usually complain most about the bottom of their heel being painful. Usually, the pain develops slowly with time and normally only one foot is affected. Some people have had both feet affected. However, the pain varies among people. Some say it's a dull pain, while others say its sharp, aching, or burning that extends from the heel outwards. The first few steps out of bed are usually where plantar fasciitis sufferers feel the worse pain, or if they have been sitting for a long time. Extended activity can cause increased inflammation and lead to flare-up of the pain. This pain is usually felt after you stop the activity rather than during.

6 DIAGNOSIS A diagnosis of PF is given by your doctor (usually your general practitioner or podiatrist) and is based largely off of a physical exam and the symptoms you are experiencing. During the exam, the provider will apply pressure to the bottom of each foot, which will give you the most pain if you have plantar fasciitis. The doctor might prescribe an X-ray of your foot to determine if your pain is due to a stress fracture bone spur, instead. TREATMENT In most cases, you can treat plantar fasciitis at home with some simple home treatments suggested to you by foot care specialists. Home Treatments It s best to rest your foot for up to six weeks and reduce the amount of walking, running, or standing you do. Support your foot with supportive shoes and arch supports. experienced reduced pain and were able to perform more activities than the other participants who stretch their Achilles tendon. Stretches should be done three to four times a day, with stretches lasting 10 seconds and repeated 10 times each session. Icing after stretching is also advised. A frozen water bottle or golf ball is helpful in effective plantar fasciitis stretches. Arch Supports You can reduce strain on your plantar fascia when you wear arch supports in your shoes. You can pick up some semi-rigid arch supports at your pharmacy which are recommended. Anti-Inflammatory Medications To help manage any discomfort and pain, you can take naproxen, ibuprofen or other nonsteroidal anti-inflammatory drugs, which can be bought over the counter. Medical Treatments by a Podiatrist Patients with plantar fasciitis benefit from getting plenty of rest and having a higher tolerance to pain. Other recommended treatments include: Stretching The Journal of Bone and Joint Surgery published a study of plantar fasciitis patients that showed that pain was reduced when the plantar fascia was stretched. The participants in the study showed that after stretching their plantar fascia for eight weeks,

7 Reduced activity. Applying ice twice a day for 20 minutes each. NSAIDS Light stretching (hamstring, calf, posterior muscle groups). Towel toe curl (Doming of Arch). Therapeutic (closed chain) exercise. Protecting area while performing activities. Gradually returning to sport activities. Preventative strategies (suitable shoe wear, orthotics, etc.). Wearing night splints is another common treatment methods as is wearing orthotics and taping the foot. Cortisone steroid injections are used in some cases. Non-surgical Some foot doctors suggest 'shock wave' non-surgical therapy to treat plantar fasciitis, reports the Los Angeles Times. This treatment involves blasting your heel with an ultrasound high-intensity beam. Other doctors use low-level lasers to treat this condition. When to Go to an Orthopedic Surgeon It's rare, but sometimes, surgery might be needed. If surgery is needed, the recovery process will be more intense. It will likely require stronger pain medications and more therapy. Recovery The recovery process from plantar fasciitis can be long; however it is important that you see it through even if your symptoms subside. Until you are completely healthy again, you need to wear a supportive shoe regardless if you are sitting on the couch or taking a shower. You should also wear a night foot splint too. Do some light stretching, take ibuprofen for pain as directed and apply ice a couple times each day. It's important that you take baby steps when working your way back to normal activity. Once you are able, you can move on to more intense glute and core exercises. Always follow up with your doctor for additional treatment or preventative measures at Nilssen Orthopedic foot and ankle center or similar centers. Orthotic Devices Orthotic insoles are recommended to help ease pain by supporting the arch. These can be bought over the counter at a drugstore or you can have them custom-made through your doctor. Other non-surgical treatments include a walking cast and therapy.

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