Plantar fasciitis is by far, the most common foot condition we see in our clinic. More often it is an injury of overuse, and symptoms are typically insidious in onset(they just creep up on you). And it is a frustratingly tenacious affliction that can become the bane of an otherwise enjoyable summer of activity. It affects any foot type; young or old; athletic or non; overweight or fit; and can last weeks or years. The most important factor in treatment is that both patients and clinicians must realize that it is a condition that often cannot be cured but controlled.

I liken fascia to thick plastic food wrap. And it functions either like a bag around our muscles or, in the case of the foot, like a hammock for your foot bones.

My patient will typically complain of:

  • Pain at the plantar medial calcaneal tubercle, which is the center of the underside of the heel bone
  • Pain that is most exquisite on initial weight bearing, either worse when they first get up in the morning or after they’ve been sitting for long periods of time; likely a result of the calf muscle, Achilles tendon and plantar fascia tightening up during rest  – to me the “trademark” of plantar fasciitis
  • The feeling of a bruised heel that is worsened with activity

TREATMENT

Initiating treatment within a couple weeks of onset is key to more successful resolution with conservative efforts. But there is no absolute intervention that works for all people.

Stretching: Flexibility is paramount. As a pedorthist, I take a comprehensive look at pelvic and lower limb mobility to determine what tissues need to be stretched, from the hip flexors, hamstrings gastroc/soleus muscle group and the plantar fascia itself; and demonstrate the proper stretching techniques, frequency and duration.

Strengthening: More evidence is giving credence to strengthening of the intrinsic and extrinsic muscles of the foot as equally important to stretching, to promote healing. Exercises are provided at our clinic through an effective home program.Check the orthokinetics web page for a copy for yourself.

Ice therapy: In most cases, ice provides symptomatic relief. Reduce the pain and inflammation through application of an ice pack 2 or 3 times a day with duration of 10-15 minutes per application and never before activity.

Taping: Taping provides some temporary relief by supporting the medial arch, thus reducing the symptoms. Great for very acute situations or while awaiting custom foot orthoses to be manufactured. This is a service provided at Ortho-Kinetics.

Custom foot orthotics: Orthotics created from a 3 dimensional cast or scan, improve foot and lower limb biomechanics, ensure proper stabilization of the medial arch and optimal support of the soft tissue of the heel pad, reducing the excessive strain on the plantar fascia, allowing for healing to take place. Our orthotics are made from 3D casting and are manufactured in house.

Night splints: Wearing a night splint at rest prevents the gastroc/soleus muscle complex and plantar fascia from shortening through the night and healing in a shortened position; a couple options are available at our clinic including the Strassburg sock.

Footwear: Unsupportive, inappropriate or worn out shoes can be a cause, and avoiding barefoot in the home is essential. As a Pedorthist, I am a shoe expert, providing proper advice on the right type of shoe for in home, work and recreational activity.

Rest: Modifying or reducing activity allows the damaged tissue time to repair and ultimately heal;

Remember, at Ortho-Kinetics, we treat every patient like a puzzle, with the goal of discovering lower limb pain and dysfunction