By Mark Plaatjes, RPT
Plantar Fasciitis is an inflammation and/or microtearing of the plantar fascia or the long plantar ligament in the foot. It is one of the most common running injuries and it can be one of the most difficult to treat. Plantar fasciitis is a complex injury that needs to be treated correctly and quickly, otherwise it can hang around for a long time, remain painful and limit the ability to run or walk without discomfort.
The most common thing to understand about plantar fasciitis is that it is most commonly a stretch injury. The stretch is most often caused by excessive pronation. It can also be stretched by having a forefoot varus (the angling or inverted position of the bones in the front of the foot relative to the heel) or the Morton’s Toe condition (in which the second toe is longer than the big toe). The plantar fascia, together with the iliotibial band, are two of the most important shock absorbers in the body. Due to inadequate cushioning, some people who have rigid high-arched feet get plantar fasciitis. People who have have lost the fat pad under their calcaneus can also get plantar fasciitis because of a lack of adequate cushioning.
Excessively tight gastroc-soleus muscle complex can also stress the plantar fascia due to a shared calcaneal insertion with the plantar fascia. It is crucial to determine what of the elements mentioned before are the cause of the plantar fascia in order to treat it successfully. Treatment of the plantar fascia consists of proper shoe selection, custom orthotics or over-the-counter inserts and physical therapy, plus ice, heat, stretching the calf muscles and anti-inflammatories.
There are several other diagnoses than can be confused with plantar fasciitis:
- Tarsal tunnel syndrome: Medial-calcaneal nerve irritation can cause pain in the rear of the foot
- Flexor digitorum brevis muscular strain: This muscle parallels the plantar fasciitis from the heel to the midfoot under the arch and the painful session of a strain can often seem like plantar fasciitis.
- A calcaneal heel spur: These bony outgrowths from the heel—often caused by by calcium deposits that develop from ill-fitting shoes—can create rear-foot irritation.
- Referral from the lumbar spin: A dull or shooting pain that extends through the sciatic nerve can create pain in the heel.
Plantar fasciitis is a complex injury that needs to be treated correctly and quickly, otherwise it can hang around for a long time, remain painful and limit the ability to run or walk without discomfort.
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