Plantar Fasciitis is a common foot condition that causes heel pain and pain in the sole of the foot. Plantar Fasciitis is inflammation of the Plantar Fascia, a fibrous sheath that runs most of the length of the sole of the foot. It attaches between the heel bone and the bones at the base of the toes, covering the small muscles in the sole of the foot. During walking and running, as you ‘toe-off’, the Plantar Fascia becomes taut and helps the foot act as a lever to push off with force. It is one of the primary stabilising structures of the arch on the inner side of the foot.

Inflammation of the Plantar Fascia usually occurs at the point where it attaches to the heel bone.Plantar Fasciitis is reasonably common in older individuals, where the movement in the joints of the foot has become restricted and strain on the Plantar Fascia is increased.
It may also occur in individuals who do a lot of standing, walking or sporting activities, usually as a result of overuse. It tends to be more common in females and in people who are overweight.
Signs and symptoms
Plantar Fasciitis produces foot pain over the inside of the heel and this usually radiates down the inside of the sole of the foot. This foot pain usually occurs with activity and is also typically present in the morning when taking the first steps of the day.
Plantar Fasciitis can be diagnosed by a doctor or physiotherapist, if pain is present on touching the affected area, and/or on stretching the Plantar Fascia (by pulling the toes up). The diagnosis of Plantar Fasciitis can be confirmed on an Ultrasound scan, when the fascia has a thickened appearance. In a small number of cases of heel pain, that fails to respond to normal treatment, it may be necessary to get an x-ray to rule out other conditions such as a bony spur on the heel bone or a fracture of the heel bone
Causes
There are a number of plantar fasciitis causes. The plantar fascia ligament is like a rubber band and loosens and contracts with movement. It also absorbs significant weight and pressure. Because of this function, plantar fasciitis can easily occur from a number of reasons. Among the most common is an overload of physical activity or exercise. Athletes are particularly prone to plantar fasciitis and commonly suffer from it. Excessive running, jumping, or other activities can easily place repetitive or excessive stress on the tissue and lead to tears and inflammation, resulting in moderate to severe pain. Athletes who change or increase the difficulty of their exercise routines are also prone to overdoing it and causing damage.
Treatments
Physiotherapy is the main treatment for this condition.
Stretching is an important treatment. If the pain is bad in the morning the foot can be stretched up by putting a towel under the forefoot and pulling up with the hands. Standing calf stretches and a night splint to hold the foot up in a partly stretched position can also be useful.
Deep massage along the plantar fascia may be useful and can be done by the sufferer once shown how by a therapist.
Ice can reduce both pain and inflammation, used from 10 to 20 minutes as an ice pack. Use care with ice and ensure your skin is protected. Do not put a freezing pack directly on your skin as this can cause frost-bite like damage.
Taping can be used by a therapist or trainer to attempt to route some of the forces through the sole along a different line.
Advice on activity modification is important as the condition may not completely resolve. Patients may need to consider alternative methods of keeping up their aerobic fitness and strength if weight-bearing activity is too painful.
Shock absorbing heel pads can be useful and should be tried as soon as the condition presents. Silicone gel pads are commonly used and are relatively cheap.
Arch supports may also be useful to restore more normal foot mechanics in cases where this has been disturbed.
Prevention
Inadequate footwear is often implicated in Plantar Fasciitis. Shoes should provide adequate support for the foot. Unsuitable footwear can increase strain of the Plantar Fascia and lead to the development of inflammation.
Insoles that support the arch on the inner side of the foot can be helpful for limiting excessive pronation and relieving stress on the Plantar Fascia and Achilles tendon.
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