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  • Northeast Wisconsin
  • February 2018
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Could you be experiencing plantar fasciitis?

Have you experienced an ache at the bottom of your heel toward your arch as you arise out of bed in the morning? An ache that may go away, but reappears when you arise from sitting or standing for a time? An ache that actually tends to get better as you walk throughout the day, only to wake up the next day and have the pain result all over again? You may be experiencing plantar fasciitis.

The most common foot problem both for the general population and active athletes is plantar fasciitis (pronounced “plantar fash-ee-eye-tis”). A condition that seems to have reached almost epidemic proportions, it eventually affects one out of every 10 U.S. residents. It is most common in people between the ages of 40 to 60 years. However, it can occur at any age. It is twice as common in women as it is in men.

Among certain populations, including runners, those who stand for long periods of time, the overweight and sedentary, the rates are much higher.

The planter fascia is a broad band of connective tissue stretching from the front of the bottom of the heel (calcaneus) to the toes (phalanges). Its purpose is to transmit stress through the foot by acting as a truss to help support the weight of the body when standing, and stabilize the foot and improve its function as a lever as part of the windlass mechanism while walking, running and jumping.

Plantar fasciitis typically causes a stabbing pain in the bottom of your foot near the heel. The pain is usually worse with the first few steps after awakening, although it can also be triggered by long periods of standing or rising from sitting. The pain is usually worse after exercise, not during.

What causes plantar fasciitis is not limited to the foot. In fact, the foot is usually only the source of pain, not the problem. It is important to diagnose why you have something rather than what you have. Treating only the site of pain, in this case the bottom of the foot may yield only frustration later on, for it is not correcting the cause of the pain. A thorough evaluation of one’s gait (walking pattern) and a hands-on evaluation to assess the biomechanics of the leg from the foot to the hip should be performed. Muscle imbalances in the leg need to be evaluated for tightness or weakness. For example, the lower leg muscles of the calf have connective tissue extensions that comprise the Achilles tendon and blend to the fascia. And trigger points of the soleus and tibialis posterior, two muscles of the calf region, refer symptoms to the bottom of the foot in the region of the plantar fascia.

The good news is in most cases the pain will ease in time. Fascia tissue, like ligament tissue, heals quite slowly. It may take several months to be symptom free. Searching the internet will inform one of direct treatment such as rest, using prescribed medication, icing, and gentle stretching and strengthening exercises. More recent literature reviews and internet posts discuss how our lifestyle and shoes have become a contributing factor to the increased incidence of plantar fasciitis, noting that incidents are lower in those countries in which many of the population do not wear shoes.

As such, if simple direct at home measures do not provide early relief, different treatment ideas and methodologies should be initiated after an experienced medical care provider does a thorough evaluation. 

Steve Barnett

I love talking about this subject, and can be reached at [email protected] As always, if you have not exercised in some time, please consult with your physician before you begin.

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