Plantar Fasciitis - An Overview

You wake up one morning and it hits you like a ton of bricks. A sharp, stabbing pain in the bottom of your heel. As you start trying to walk it may progressively ease up...but if you sit for a period of time, there it goes again! Welcome to the not-so-exclusive club of Plantar Fasciitis. You are in good company - approximately 25% of adults will experience heel pain at some time.

The plantar fascia is a ligament that attaches to the heel and extends through the arch. Due to an injury, or just longstanding biomechanical imbalance, the attachment of the fascia to the heel becomes inflamed. In order to appropriately manage this, both the inflammation and the mechanics must be addressed.

Treatment of inflammation is a modification of the 'RICE' principle: Rest, Ice, Compression, and Elevation. In the case of plantar fasciitis, ice is most helpful. Anti-inflammatory medication is also useful. In extreme cases, an injection of cortisone can be used to quickly manage the inflammatory process.

Without mechanical control, all the anti-inflammatory measures will be for naught. Initially this can come in the form of a taping or strapping to splint the plantar fascia ligament. An off-the-shelf supportive insole can be used as well. In many cases a custom orthotic device will best serve to neutralize the pathological mechanics adn best prevent a reoccurrence of plantar fasciitis.

One thing that needs to be mentioned is that plantar fasciitis is not a sign of aging. On the contrary, it is a syndrome of activity. In my Houston practice, I have treated patients with plantar fasciitis who are as young as in their 20's. Don't assume it will go away on its own, however. Be sure to visit your podiatrist to get you out of pain as quickly as possible!
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