The plantar fascia is made up of 3 distinct parts: the medial, central, and lateral bands. The central plantar fascia is the thickest and strongest section, and this segment is also the most likely
to be involved with plantar fasciitis. In normal circumstances, the plantar fascia acts like a windlass mechanism to provide tension and support through the arch. It functions as a tension bridge in
the foot, providing both static support and dynamic shock absorption.
Plantar fasciitis symptoms are usually exacerbated via "traction" (or stretching) forces on the plantar fascia. In simple terms, you plantar fascia is repeatedly overstretched. The most common reason
for the overstretching are an elongated arch due to either poor foot biomechanics (eg overpronation) or weakness of your foot arch muscles. Compression type plantar fascia injuries have a traumatic
history. Landing on a sharp object that bruises your plantar fascia is your most likely truma. The location of plantar fasciitis pain will be further under your arch than under your heel, which is
more likely to be a fat pad contusion if a single trauma caused your pain. The compression type plantar fasciitis can confused with a fat pad contusion that is often described as a "stone
When plantar fasciitis occurs, the pain is typically sharp and usually unilateral (70% of cases).Heel pain worsens by bearing weight on the heel after long periods of rest. Individuals with plantar
fasciitis often report their symptoms are most intense during their first steps after getting out of bed or after prolonged periods of sitting. Improvement of symptoms is usually seen with continued
walking. Numbness, tingling, swelling, or radiating pain are rare but reported symptoms. If the plantar fascia continues to be overused in the setting of plantar fasciitis, the plantar fascia can
rupture. Typical signs and symptoms of plantar fascia rupture include a clicking or snapping sound, significant local swelling, and acute pain in the sole of the foot.
To arrive at a diagnosis, the foot and ankle surgeon will obtain your medical history and examine your foot. Throughout this process the surgeon rules out all the possible causes for your heel pain
other than plantar fasciitis. In addition, diagnostic imaging studies such as x-rays or other imaging modalities may be used to distinguish the different types of heel pain. Sometimes heel spurs are
found in patients with plantar fasciitis, but these are rarely a source of pain. When they are present, the condition may be diagnosed as plantar fasciitis/heel spur syndrome.
Non Surgical Treatment
Plantar fasciitis treatment can be conservative (non-surgical) or invasive (surgical). Among the non-surgical ways to manage plantar fasciitis involves stretching and icing exercises. A night splint
which help stretch the Achilles tendon and plantar fascia overnight, so that they can be more easily stretched during the morning. Orthotics that can be custom-made for the feet can also distribute
tension on the feet more consistently. Corticosteroid is injected into the affected area to relieve pain and decrease inflammation. Doctors may also use extracorporeal shockwave therapy before
considering plantar fasciitis surgery. During the therapy, sound waves are used to stimulate the affected area and eventually heal it. Physical therapy incorporation, deep massage stretching, and
other modalities can at times be a helpful adjunct treatment. Surgery for plantar fasciitis is only considered when all other conservative treatments have failed.
Like every surgical procedure, plantar fasciitis surgery carries some risks. Because of these risks your doctor will probably advise you to continue with the conventional treatments at least 6 months
before giving you approval for surgery. Some health experts recommend home treatment as long as 12 months. If you canât work because of your heel pain, canât perform your everyday activities or
your athletic career is in danger, you may consider a plantar fasciitis surgery earlier. But keep in mind that there is no guarantee that the pain will go away completely after surgery. Surgery is
effective in many cases, however, 20 to 25 percent of patients continue to experience heel pain after having a plantar fasciitis surgery.
Stretching your plantar fasciitis is something you can do at home to relieve pain and speed healing. Ice massage performed three to four times per day in 15 to 20 minute intervals is also something
you can do to reduce inflammation and pain. Placing arch supports in your shoes absorbs shock and takes pressure off the plantar fascia.