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Plantar Fasciitis

Will my heel pain ever go away”?  is a question I hear frequently from my patients.  Plantar fasciitis is as much a condition as an injury, caused by impact trauma, repetitive micro trauma, foot imbalance, improper shoes, or inadequate foot support.  It is very common if we have gained weight or become inflexible through age and lack of physical activity.  Our tissues become softer and weaker.  Plantar fasciitis has been present or is currently present in close to 20% of active patients.  With conservative mechanical treatment about 90% of those will have complete relief.  They will need to continue protecting and supporting their feet with correct shoes and foot orthotics as they return to activities.  The pain goes away, but the condition does not go away.  For more complete review of medical and surgical treatments please see the Podiatry Today article on this website.

This paper explains how to rehabilitate from heel pain, what you can do to relieve this painful condition and prevent its return.  Standard treatments for acute (sharp) pains for any injury include R.I.C.E. – Rest, Ice, Compression, and Elevation.  Treatment for chronic plantar fasciitis and the heel spur syndrome include the proper shoes, custom made biomechanical foot orthotics, appropriate stretching, massage, and strengthening exercises for your feet and lower legs.  Always warm up to any activity; never jump into a sport.

Avoid jumping or vertical impact sports such as step classes, jumping rope, running stairs, etc.  The first thing in the morning, even before you get out of bed, warm up your feet and ankles before stepping into your slippers, clogs or shoes with orthotics.  Avoid going barefoot!

Remember that the two major attachments to the heel bone are the calf muscle aas it attaches to the back of the heel bone with the Achilles tendon pulling upward, and the bottom of the heel with the plantar fascia pulling forward, essentially pulling the heel bone in two directions at the same time putting sever stress on these attachments.  This traction produces heel spurs.  Anything you can do to relieve tension on the heel bone will give some relief.  Extensive research and helpful products are listed at heelpain.com and foot.com but very little is written on how to tape your feet, or how to prevent expansion, spreading out, and collapse of the foot.

If you currently have, or have had plantar fasciitis, you need to continue these procedures on a regular basis.  Stretching and strengthening exercises for rehabilitation are exactly the same as those exercises taught to us by physical therapists and trainers that will protect us from injury and prevent return of repetitive motion injuries.  This sounds silly, but remember to stretch your Achilles tendons at least twice a day while brushing your teeth, and before any physical activity.