Chino Summit Podiatry
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Plantar Fasciitis Call Today at 909.627.6364
Plantar Fasciitis is one of the most common causes of heel pain. Dr. Schafer often treats this very common problem of plantar fasciitis with complete diagnostic services, non surgical and state of the art surgical options for plantar fascitis (a common misspelling) treatment
Anatomy:
The plantar fascia is a strong ligament on the bottom of the foot. It begins at the heel bone as one band and runs the along the entire bottom of the foot fanning out towards the toes. The plantar fascia is an actual continuation of the Achilles tendon and helps transfer the pull of the Achilles to the foot during walking.
Problems with the Plantar Fascia:
The plantar fascia acts to support the inside arch of the foot. As one walks, the plantar fascia will stretch and contract as the weight is put through the foot. The problem occurs when the ligament is under constant stress and stretch such as with flat feet or tightness of the fascia. The ligament will begin to tear off from its origin in the heel bone. After several small tears develop inflammation of the area develops leading to the name plantar fasciitis (-itis means inflammation).
What is a Heel Spur and does it matter:
A heel spur is extra bone on the bottom of the heel associated with the constant overpull of the plantar fascia on the heel. When there is a pulling on a bone attachment from a ligament or a tendon, bone will respond by growing in the direction of the pull. In the case of the plantar fascia, when the ligament is tight and on a constant stretch for many months and years a bone spur can grow in the area. The bone spur itself is not painful or problematic in most cases. It is when the plantar fascia begins to tear from the area that plantar fasciitis can occur. One can have a very large heel spur and no plantar fasciitis or pain, and one can have a great deal of pain and no spur at all. The spur is simply a measure of the length of time the ligament has been short and tight.
Symptoms of Plantar Fascitis:
The pain of plantar fasciitis is most commonly felt in the bottom of the heel towards the inside of the foot. Patients describe the pain as deep and achy and sharp at times. The main pain is with first steps after resting or not being on the foot for some time. With walking, the pain gets better and may even go away. The reason for pain with first steps is that the fascia gets tight overnight or with sitting and the first steps cause a severe stretch and tearing that causes pain.
There should be no burning pain or sharp nerve pain with plantar fascitis and there should be no deep aching pain. Often, plantar fascitis is confused with a pinched nerve or stress fracture of the heel.
Diagnosis:
The most important process in the treatment of plantar fasciitis is the initial diagnosis. Too often, the diagnosis is not correct or a guess is made and the proper treatment is not started. Diagnosis is made with x-rays to make sure there is no fracture or tumor of the region. Ultrasound is used to check the fascia itself and make sure there is no tear and check the level of scar tissue and damage. The less damage, the more likely conservative care will take care of the problem.
Conservative treatments will heal the plantar fascitis 85% of the time. The initial therapy will stretching exercises to improve flexibility (especially in the mornings), physical therapy to calm the pain, and anti-inflammatory medication. The nice thing about a plantar fasciitis night splint is that you can use it while you're sleeping. Most patients will also need custom molded orthotics to help control the motion in the foot and take the strain off the plantar fascia. If pain continues a cortisone injection may be used to calm the severe swelling and use of a night splint to hold the fascia stretched out at night may be added to the treatment. Again, the more conservative therapies the patient undergoes, the more likely that surgical correction will not be necessary.
Surgical care consists of doing a release of the tight band of the plantar fascia. The name for the procedure is the endoscopic fascial release.
Anatomy:
The plantar fascia is a strong ligament on the bottom of the foot. It begins at the heel bone as one band and runs the along the entire bottom of the foot fanning out towards the toes. The plantar fascia is an actual continuation of the Achilles tendon and helps transfer the pull of the Achilles to the foot during walking.
Problems with the Plantar Fascia:
The plantar fascia acts to support the inside arch of the foot. As one walks, the plantar fascia will stretch and contract as the weight is put through the foot. The problem occurs when the ligament is under constant stress and stretch such as with flat feet or tightness of the fascia. The ligament will begin to tear off from its origin in the heel bone. After several small tears develop inflammation of the area develops leading to the name plantar fasciitis (-itis means inflammation).
What is a Heel Spur and does it matter:
A heel spur is extra bone on the bottom of the heel associated with the constant overpull of the plantar fascia on the heel. When there is a pulling on a bone attachment from a ligament or a tendon, bone will respond by growing in the direction of the pull. In the case of the plantar fascia, when the ligament is tight and on a constant stretch for many months and years a bone spur can grow in the area. The bone spur itself is not painful or problematic in most cases. It is when the plantar fascia begins to tear from the area that plantar fasciitis can occur. One can have a very large heel spur and no plantar fasciitis or pain, and one can have a great deal of pain and no spur at all. The spur is simply a measure of the length of time the ligament has been short and tight.
Symptoms of Plantar Fascitis:
The pain of plantar fasciitis is most commonly felt in the bottom of the heel towards the inside of the foot. Patients describe the pain as deep and achy and sharp at times. The main pain is with first steps after resting or not being on the foot for some time. With walking, the pain gets better and may even go away. The reason for pain with first steps is that the fascia gets tight overnight or with sitting and the first steps cause a severe stretch and tearing that causes pain.
There should be no burning pain or sharp nerve pain with plantar fascitis and there should be no deep aching pain. Often, plantar fascitis is confused with a pinched nerve or stress fracture of the heel.
Diagnosis:
The most important process in the treatment of plantar fasciitis is the initial diagnosis. Too often, the diagnosis is not correct or a guess is made and the proper treatment is not started. Diagnosis is made with x-rays to make sure there is no fracture or tumor of the region. Ultrasound is used to check the fascia itself and make sure there is no tear and check the level of scar tissue and damage. The less damage, the more likely conservative care will take care of the problem.
Plantar Fasciitis Splint
Conservative treatments will heal the plantar fascitis 85% of the time. The initial therapy will stretching exercises to improve flexibility (especially in the mornings), physical therapy to calm the pain, and anti-inflammatory medication. The nice thing about a plantar fasciitis night splint is that you can use it while you're sleeping. Most patients will also need custom molded orthotics to help control the motion in the foot and take the strain off the plantar fascia. If pain continues a cortisone injection may be used to calm the severe swelling and use of a night splint to hold the fascia stretched out at night may be added to the treatment. Again, the more conservative therapies the patient undergoes, the more likely that surgical correction will not be necessary.
Surgical care consists of doing a release of the tight band of the plantar fascia. The name for the procedure is the endoscopic fascial release.
