Hi, I am Dr. Satwinder Gosal with The Center for Morton’s Neuroma. Plantar Fasciitis is one of the most common causes of heel pain. Your plantar fascia consists of three bands of ligaments that start from the insertion point in your heel to the ball of your foot. Plantar fasciitis is the inflammation and stress of plantar fascia resulting in small tears and pain. People suffering from plantar fasciitis often say that the first steps of the day are the most painful. They also complained of pain with walking after sitting for more than half an hour. The pain will usually subside after a few minutes of walking. Plantar fasciitis painusually also subsides at rest and should not keep you up at night. The pain can be varied from all the way from a dull ache to a sharp stabbing pain of the heel. Plantar fasciitis can occur due to many reasons such as trauma, repetitive stress injury, poor biomechanics and non supportive shoes. Risk factors include obesity, repetitive injury, stress, high arch foot, overpronation, recently increased activity and cap tightness due to lack of stretching. Heel spurs can also be present in people with plantar fasciitis but are not the cause of pain. The key to successful treatment is to get treatment early.

Hi, I am Dr. Satwinder Gosal of The Center for Morton’s Neuroma. I am here to talk to you about the treatment of acute plantar fasciitis. Stretching is key: stretching every day, keeps the podiatrists away. You should try your plantar fasciitis stretching regiment which can be downloaded from our website. In addition, you can perform 2 to 3 reps of stretching exercises every morning before getting out of bed, which should help you get out of bed. You have been sitting for more than 10 minutes? Or after driving perform simple stretching exercises before getting up. A night splint can help stretching. Do your best to wear it every night. Most people find it difficult to wear it at bed. So, try wearing it when resting or watching TV. Just prop your leg up on a supportive structure while wearing the splint. Icing is helpful with inflammation. I recommend throwing the water bottle in the freezer at home or at work. Roll the frozen water bottle along the bottom of your foot for 10 minutes at a time. Insert orthotics play an important role in treating acute and chronic plantar fasciitis. I highly recommend trying an over the counter insert to help control excessive motion and provide support. If you get relief with the insert, think right!! But, sometimes depending on your foot structure and mechanics custom orthotics are needed. Shoes play a crucial role too. If you can bend or twist your shoe, stay away from it. I highly recommend getting fitted for an appropriate athletic shoe at a Running Store. Wearing shoes with the appropriate width and size is important. And shoes with slight heel or heel lift can help symptoms as it takes the pressure of the heel. If you are experiencing excruciating heel pain, you can wear walking boot, which makes it a lot better. But, you will need to wear it for 46 weeks, which is often difficult for people to do. Non-compliance with wearing the boot is the reason this treatment often fails. Ultrasound guided steroid injections can also help by reducing inflammation. One must be careful as there are real risks of plantar fascial rupture with each injection. No more than 3 steroid injections should be administered in a year. One should be educated on the rupture risk, the risk of soft tissue atrophy, skin discoloration and steroid flare before deciding on an Ultrasound Guided Steroid Injection. We recommend Extracorporeal Shock-Wave therapy as an excellent alternative with simple, relatively painless and has a very success rate. The usual treatment course is a set of 2 twenty minutes treatment and you generally only need once or twice. Physical therapy is very important in treating plantar fasciitis. A physical therapist can help and guide you with stretching and strengthening, also assess your gait, perform a biomechanical analysis from head to toe. This can assess you for anything that may have contributed to your plantar fasciitis. And remember the most important thing is to go to a clinician experienced in the treatment of plantar fasciitis.