Plantar fasciitis: A common cause of foot pain

By Joseph M. Harris, PT, ATC, CEAS - President/Clinical Director - Physical Therapy Solutions, PSC

Plantar fasciitis affects over 2 million people a year and is a very common cause of foot pain. Plantar fasciitis is inflammation or strain of the tissue on the bottom of the foot. It occurs as a result of either poor biomechanics or overuse of the foot.

Very often one will develop plantar fasciitis after increased physical activity or with improper footwear. Poor biomechanics will, many times, result in increased foot pain when activity is increased. Many times a person will increase his or her exercise regimen or increased walking at work which results strain of the foot and plantar fasciitis. If one has abnormal foot structure or function, improper foot support or increased activity is more likely to lead to plantar fasciitis. Increased body weight can also contribute to the onset of plantar fasciitis. Arthritis can cause plantar fasciitis by causing inflammation in the tendons of the foot. Risk factors include increased activity, prolonged standing at work, pregnancy, diabetes, hormonal changes, and abnormal foot anatomy such as flat feet or high arches. Also, footwear that does not offer good arch support, such as high heels or boots, increases risk of developing plantar fasciitis.

People with plantar fasciitis typically complain of pain over the bottom of foot, especially near the heel. Usually pain is worst upon awakening, when the person first places the foot to the ground. Pain usually improves but then worsens by the end of the day with activity. Tenderness also develops along the bottom surface of the foot. Redness and swelling may also be present.

Conservative treatment is often effective. Physical therapy would include modalities that would help to improve the mobility flexibility of the foot and decrease inflammation. Manual therapy techniques and stretching exercises are also used to improve flexibility. Shoe inserts are also very effective in decreasing pain by helping to support the arch, improving biomechanics and decreasing pain with activity. Sometimes, the patient is placed in splints overnight to help stretch the calf and keep the plantar fascia from tightening over night. Activity modifications are also made when appropriate. Injections are sometimes tried by the physician but tend to be painful. Surgery is often a last resort.

Prevention of plantar fasciitis is important. Be sure to start new exercise routines slowly. Be sure footwear fits properly and that you have good support of your feet. Maintain good flexibility of the foot and lower leg. Also maintaining the proper weight helps to decreased the risk of developing plantar fasciitis. If you are having foot pain, proper diagnosis by your health care provider is important in receiving effective treatment.

By Joseph M. Harris, PT, ATC, CEAS

President/Clinical Director

Physical Therapy Solutions, PSC

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