Plantar Fasciitis

“I work out and my heel hurts.” “I run and I am fine, it’s afterwards, my heel hurts.” “I stand all day at work and my heel hurts.”

Some of you may be familiar with the above statements. Some of you are looking for the quick fix, the magic stretch or device to make the “hurt” go away. I hear this a lot from customers and patients of the practice who visit me at the store. It is hard to see the look of despair particularly of runners who want to eliminate this “hurt” they cannot seem to control themselves. When a patient is diagnosed with Plantar Fasciitis from their Podiatrist, they are in a frantic search to make the pain go away fast. Rightfully so as they want to get back to life prior to the diagnosis.

So lets review exactly what this is and options on what to do once you have been told you in fact have good ole Plantar Fasciitis or also known as PF….

How do you say Plantar Fasciitis?
PLAN-tar fashee-EYE-tiss. It’s intriguing to hear from people their version however, this is the correct way to pronounce the words.

What does the Plantar Fascia do?
The plantar fascia is the thick ligamentous band in the bottom of the foot which is attached to the heel. The band runs forward and inserts into the ball of the foot. The plantar fascia encapsulates muscles in the bottom of the foot, however the main function is to support the arch of the foot by acting as a bowstring that connects the ball of the foot to the heel. This "support" enables us to propel ourselves forward more effectively.

Where exactly is the pain located?
Plantar fasciitis pain is found in the center or toward the inner side of the bottom of your heel. A lot of people notice the pain when they stand up after any period of rest especially after sleeping all night. After walking around for a bit, the pain can lessen or virtually disappear.

The interesting thing about this is PF is not caused by the heel striking the ground. PF is often referred to as heel spur syndrome however the spur is not the actual cause of pain. The spur is a sign the PF has been stressed for a period of time. Heel spurs are deposits of calcium in the plantar fascia where it attaches to the heel. You see, a spur is your body trying to respond to the injury and inflammation. So you really cannot blame the spur for causing the pain. It’s actually pretty common for people to have spurs and not have pain.

What caused my Plantar Fasciitis?
Common situations are:
An increase in activity. I.E. cutting grass in the spring on uneven ground and wearing improper footgear.
Biomechanical issues of the foot
A sudden injury
Wearing the wrong shoes
Weakened/Inflexible calf muscles
BEING OVERWEIGHT
Spending too much time on your feet
Or, quite frankly, it could be just one of those mysteries of life.

Notice the culprit listed in bold capitol letters above? Yep, your weight has a heck of a lot to do with PF. If you think about it, the foot must take on significant weight on a constant basis. Each step taken, the body weight is absorbed through both feet. The heel takes the brunt of the pressure. When the load is greater than what can be physically tolerated, damage starts and PF begins.

Does this mean fit people including star athletes cannot have PF? Absolutely not. Even football greats such as Eli Manning, quarterback of the New York Giants is in fact dealing with PF as I write this blog.We do however notice individuals who could be more fit for themselves often dealing with PF as opposed to those who control their weight.

So how do I fix it?
Here are a couple of thoughts on fixing PF....

You need to have your feet checked out by a Podiatrist to rule out if in fact you have PF or if there is another cause to your pain.

Wear the appropriate shoes. Don’t know what to wear – consult your local Certified Pedorthist.

If determined the appropriate shoe does not resolve the issue, orthotics are often utilized. Over the counter or custom orthotics may be helpful.

Physical Therapy – if recommended by your Podiatrist, PT can provide amazing results. The key with PT is you have to stick with the program!

Patience - Many people are frustrated when they are not seeing immediate results. As mentioned earlier, recovery takes time.

Finally, it all boils down to this...you need to follow your Podiatrist’s recommendations. No cheating here. PF can be controlled. You need to realize this simply does not go away overnight and it takes time. In some cases, surgical interventions are necessary after exhausting all other treatment avenues. If you truly want to get back to your routine whether it be walking or running or simply to stand up without heel pain, you need to follow the course of treatment which may include one or all of the above.

A note to the ladies….During treatment, your shoe fashion may result in quality athletic shoes. Future shoe options may require more focus than the cutest trends or the sale on the buy one get one teasers. It is a hard transition for some, but quite frankly, don’t you owe it to yourself and your feet?

Healthy Steps….for your feet….for your life!