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What is the Plantar Fascia?
The plantar fascia is a ligament-like band extending between the calcaneal tuberosity and the proximal phalanges of the toes. It has a triangular shape, with a small attachment area at the heel and a significant widening to nearly the entire width of the foot at the level of the metatarsophalangeal joints. The plantar fascia supports the longitudinal arch of the foot and absorbs pressure during walking and running. As the terminal element transmitting forces generated by the gastrocnemius muscle to the calcaneus and subsequently to the toes, this structure is prone to frequent injuries.
What is Plantar Fasciitis?
Plantar fasciitis is one of the most common causes of heel pain. It occurs when the plantar fascia becomes irritated and inflamed. The fascia endures significant stress during prolonged standing, walking, or running, leading to wear and tear. This can result in inflammation, causing pain and stiffness in the heel. Such discomfort may disrupt daily life and even hinder mobility. Depending on the severity of plantar fasciitis, relief may be achieved through non-surgical treatments, while severe cases may require surgical intervention.
What Causes Plantar Fasciitis?
Plantar fasciitis can have multiple causes. The most common is foot overuse due to increased tension in the fascia and calf muscles. It may result from minor, repetitive injuries or strains over time. Plantar fasciitis often affects physically active individuals and is associated with poor technique in sports, inappropriate footwear, or poorly fitted orthotic insoles. Runners are particularly at risk, especially those running on hard surfaces or rapidly increasing training intensity and load.
Risk Factors for Plantar Fasciitis
- New or intensified physical activity
- Prolonged standing during work
- Frequent tight calf muscles
- Anatomical predispositions such as flat feet or high arches
- Obesity
- Age between 40 and 60 years
Main Symptoms of Plantar Fasciitis
The primary symptom of plantar fasciitis is dull or sharp pain in the lower heel near the calcaneal tuberosity. It typically affects one foot but can involve both. Pain usually develops gradually over time and is most intense in the morning, upon waking, or when taking the first steps after prolonged sitting. Climbing stairs may be problematic due to heel stiffness. Individuals with plantar fasciitis often experience pain not during physical activity but afterward.
How to Relieve Plantar Fasciitis at Home
- Rest is crucial; elevate the affected foot and support it on a chair.
- Avoid prolonged walking or standing.
- Apply ice packs (wrapped in a towel) to the painful area for about 20 minutes every 2-3 hours.
- Use over-the-counter pain relievers.
- Perform gentle stretching exercises.
- If overweight, try to reduce to a healthy weight.
- Avoid wearing high heels.
- Use footwear with good arch support or custom orthotic insoles.
Diagnosis of Plantar Fasciitis
If pain persists despite following the above recommendations, consulting an orthopedic specialist is essential. A medical history and physical examination are key to diagnosis. Understanding the circumstances and triggers of the pain is crucial. In some cases, imaging diagnostics such as X-rays or ultrasound may be helpful.
How to Treat Plantar Fasciitis Quickly?
Prompt action upon noticing the first symptoms is vital to avoid prolonged treatment and rehabilitation. Reducing physical activity or taking a break from it altogether until pain subsides is recommended. Physical therapy is highly effective in non-surgical treatment. A skilled physiotherapist can accelerate tissue healing through manual therapy. Home exercises, such as stretching the plantar fascia, calf muscles, and hamstring muscles, as well as massaging the fascia with a tennis ball, are the next steps. Custom orthotic insoles can also be a valuable part of treatment.
Surgical Treatment for Plantar Fasciitis
Surgery for plantar fasciitis is considered when non-surgical methods fail. The procedure is typically performed endoscopically using minimally invasive techniques. Two small incisions allow the introduction of tools, including a camera and visual pathway. The surgery often involves removing inflamed or scarred tissue and partially releasing the plantar fascia. This intervention has minimal impact on foot structure and carries a low risk of complications. Immobilization with a cast is not required post-surgery. Patients are instructed on rehabilitation exercises the day after surgery and usually leave the hospital shortly afterward. Crutches are recommended for two weeks to alleviate pain, enabling a rapid return to full physical functionality.
Exercises for the Plantar Fascia
1. Foot Rolling with a Tennis Ball: Roll the ball along the length of the plantar fascia. Start at the heel and roll toward the toes, then back again. Perform this in both directions.
2. Toe Raises Using a Stepper: Move through the full range of motion, from maximum stretch to complete muscle contraction.
3. Towel Curling with Toes: Use all toes to slowly and controlledly curl a towel toward yourself.
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Learn about other possible foot and ankle injuries.
Bibliography:
- Healthline - Plantar Fasciitis - Medically reviewed by Deborah Weatherspoon, Ph.D., MSN — By Jennifer Larson — Updated on February 26, 2023
- National Library od Medicine - Plantar Fasciitis - Benjamin K. Buchanan; Donald Kushner - 2022
- Lemont H, Ammirati KM, Usen N. Plantar fasciitis: a degenerative process (fasciosis) without inflammation. Journal of the American Podiatric Medical Association. 2003 May 1;93(3):234-7.
- Plantar fasciitis - Authors: S Cutts, N Obi, C Pasapula, and W ChanAUTHORS INFO & AFFILIATIONS, Publication: The Annals of The Royal College of Surgeons of England - Volume 94, Number 8
