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What is Plantar Fasciitis?
Plantar Fasciitis is a thickening of the plantar fascia which is a band in the arch of the foot. Plantar Fasciitis often causes tenderness, pain and swelling around the heel of the foot.
Have you ever felt pain along the inside heel of your foot? A throbbing searing or piercing pain that is just on the heel of your foot without any tingling or radiation? It might feel like your heel is walking on a stone or you have a bruising heel pain.
Has your pain gradually worsened but now is especially bad when you take your first steps in the morning and then generally fades after about 30-45 minutes?
If so, you may have Plantar Fasciitis. Sometimes it is referred to as heel-pain syndrome. It is caused by degeneration of plantar fascia as a result of persistent overuse injury. Specifically, Plantar Fasciitis is a result of micro trauma leading to degeneration and small tears of the plantar fascia. Poorly managed plantar fasciitis can significantly worsen your quality of life by interfering with your ability to do day-to-day activities.
The vast majority cases of plantar fasciitis resolve within a few months with the correct conservative management. But the longer you experience plantar fasciitis pain or delay seeking treatment, the less likely you will improve from conservative treatment.
for a more in depth discussion of Plantar Fasciitis Click Here.
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How Common is Plantar Fasciitis?
- Most cases of plantar fasciitis occur in middle aged individuals (peak age of occurrence is 40 to 60 years).
- Approximately 80% of all cases of heel pain are due to Plantar Fasciitis.
- It is estimated that 1 of 10 individuals are at risk of experiencing at least one episode of disabling heel pain at some point in life.
- 8% of foot injuries in runners are related to Plantar Fasciitis.
- Some estimates report that 10-16% of the population suffer from Plantar Fasciitis.
- Approximately 1% of all visits to the orthopedists office are due to plantar fasciitis (this corresponds to about 2 million visits per year!)
- Plantar fasciitis involves both feet in almost ⅓ of all cases.
What is Plantar Fasciitis and What Causes Plantar Fasciitis Video:
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What is the Plantar Fascia?
The Plantar Fascia is the thick broad band of connective tissue that supports the arch of the foot. It connects the heel bone with your toes. Inflammation or damage to this band can produce characteristic symptoms of tenderness, pain and swelling of the base of the foot.
Risk Factors for Plantar Fasciitis
Anatomical Factors
- Obesity: Obese or overweight individuals are more prone to develop plantar fasciitis due to persistent stress and strain on the plantar fascia and related ligaments. Obesity also affects the cartilaginous tissue as well as other connective tissue elements in your limbs aggravating the degeneration.
- Flat feet (Pes planus): Individuals with flat feet deformity (or fallen arches) are also at high risk of developing plantar fasciitis. This happens mainly because of the entire sole of the foot comes in direct contact with the ground. It is believed that 20 – 30% of the general population has this foot deformity and are in high risk factor for developing plantar fasciitis.
- Shortened Achilles tendon: A short Achilles tendon is associated with toe walking, abnormal motor development and loss of coordination in children; thereby aggravating the risk of injury or damage to the plantar fascia
- High-arched feet (Pes cavus): Abnormal weight distribution while walking due to disrupted arch of the foot can augment the damage to the plantar fascia. This abnormal distribution occurs more commonly while standing or walking.
Biomechanical Factors
- Over pronation (inward rolling of the foot) is the most common risk factor that is associated with plantar fasciitis in 86% of the cases. This is often seen in individuals with flat feet syndrome.
- Limited ankle bending (or dorsiflexion)of less than 10 degrees is considered a major risk for plantar fasciitis. Approximately 50% to 83% of cases of Plantar fasciitis cases are believed to be associated with limited ankle dorsiflexion.
- Weak muscles of the foot: Strong muscles of the foot support the major arch of the foot, the longitudinal arch. Any disease, damage or injury that affects the strength of the internal muscles of the foot (the intrinsic muscles) can increase the risk of plantar fasciitis.
Extrinsic and Environmental Factors
- Running athletes: Certain exercises expose your plantar ligaments and connective tissue components to undue stress (especially in the region of heels). In poorly managed cases, this may lead to plantar fasciitis. Professional athletes and sports personnel involved in ballet dancing, basketball, marathon running, gymnastics, soccer, tennis and dance aerobics are at high risk of developing plantar fasciitis. Other associated risk factors include; poor conditioning, inadequate stretching/ warm-up before and after exercise, and walking barefoot.
- Occupations that involve prolonged standing: Occupations that demand longer hours of standing or walking on rigid surfaces can predispose you to develop plantar fasciitis. High risk occupations include factory workers, soldiers and teachers etc.
- Poor footwear: Plantar fasciitis is fairly common in individuals who wear ill-fitting footwear. This includes, shoes with poor arch support or extremely worn out shoes. This risk increases significantly in individuals who walk on hard surfaces, or are involved in prolonged weight bearing activities.
Clinical Description
- Plantar Fasciitis pain usually has a typical clinical pattern: The pain is often described as a throbbing, searing or piercing pain along the bottom of the heel. The exact location in the heel region can vary from person to person, but the pain doesn’t radiate. The pain can be on the inside of the heel, the middle of heel or even in the arch. There are usually no accompanying feelings of tingling or pins and needles.
- Plantar fasciitis usually has a slow onset of symptoms that can gradually worsen over time but a recent increase in body weight or activity changes can trigger Plantar Fasciitis.
- Patients with Plantar fasciitis report their worse pain and stiffness after arising from the bed in the morning or after long periods of rest. Interestingly, people who cover a long commute to work experience little to no discomfort during the commute. However, as soon as they attempt to weight-bear again the pain can worsen. The discomfort subsides slowly over the next 30-45 minutes with walking or stretching but worsens towards the end of the day.
Complications:
Most people tend to ignore the symptoms of dull burning pain in the heel region, until it begins to affect their quality of life. For example, in some cases, individuals tend to adopt abnormal walking patterns to decrease the likelihood of acute pain attacks; however, this greatly aggravates the risk of further connective tissue damage and may lead to:
- Plantar Fascia tear
- Knee pain
- Back discomfort
- Hip pain and osteoarthritis
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This information is for educational purposes only and is NOT intended to replace the care or advice given by your physician. Always seek the advice of your physician or other qualified health provider before starting any new treatment or with any questions you may have regarding a medical condition. For more information see our Medical Disclaimer.
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