Do you have heel pain? It could be plantar fasciitis. The most common cause of heel pain is plantar fasciitis. It is thought to be due to a repetitive and degenerative process rather than an acute injury. The Plantar Fascia is a thick tendon-like structure which extends between the heel bone and the forefoot. Although the plantar fascia is tendon-like it is not a tendon rather, it is a thick band connecting the heel bone (Calcaneus) and the forefoot.

Heel Pain

Heel pain is very common. People with plantar fasciitis usually describe a sharp stabbing or burning pain which is worst first thing in the morning or when standing up. Although the plantar fascia attaches to both the heel and the forefoot plantar fasciitis pain is only perceived at the heel.

What is the main cause of plantar fasciitis?

People with flat feet or a very high arch tend to suffer from plantar fasciitis more than those who do not fall into either of these categories. Also, People with a shortened calf muscle, Gastrocnemius, or higher leg muscles are predisposed to plantar fasciitis. Limited ankle range of motion, excess pronation or supination are also contributing factors. Other factors which can contribute to heel pain include obesity, atrophy of the heel pad, standing for long periods and even aging.

What is a Heel Spur?

When heel pain has gone on for a period of time calcium can deposit onto the plantar fascia and a spur may develop. According to literature about half of people with heel pain develop a spur. The presence or absence of a spur has no bearing on the amount of pain experienced by the patient. In fact, when treatment is successful, the patient no longer has any pain but the spur remains intact. To be pain-free is the goal of treatment.

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Image represents an illustration of the Plantar Fascia as it originates and inserts onto the heel bone, also illustrated is the location of a Heel Spur.
An illustration of the anatomy of the Plantar Fascia and a Heel Spur.

According to the National Institues of Health, NIH; https://www.ncbi.nlm.nih.gov/books/NBK431073/ Plantar fasciitis accounts for 10% of all runner-related injuries and 11-15% of all foot-related injuries requiring medical care.

Some Terminology

Interestingly, in the strict sense of the microscopic world, only a tendon tear or partial tear would involve an acute or short term injury. Therefore, all long term or chronic plantar fascia abnormality is referred to as fasciosis or fasciopathy. Chronic plantar fasciopathy is extremely common.

Image identifies the location of pain as the bottom of the heel, where Plantar Fasciitis pain typically occurs.
The typical location for Plantar Fasciitis pain

What is the best treatment for plantar fasciitis?

Regardless of whether the fasciitis is acute or chronic the treatment is the same. Most physicians recommend a course of physical therapy, stretching exercises, orthotics or arch supports or a steroid injection. A study published in 2018 found that platelet-rich-plasma, PRP, actually was a better longterm solution to plantar fasciitis than a steroid injection in a 12-month follow up. PRP uses the patient’s own blood as the injectate, thereby reducing side effects. Other treatment options include botulin toxin (botox) injection, orthotics, heel cups and night splints. Treatment can take anywhere from six weeks to one year.

What To Do For Heel Pain

If you think you have plantar fasciitis try to stretch your arch before you get out of bed in the morning, before standing up from a chair, before and after exercising, etc. To do the stretch properly pull your toes toward the front of your shin, next pull your toes even closer to your shin; you should feel a light pull. Hold this stretch for a few seconds, now rest. Do this stretch 3 or more times before standing up. An other thing to try is an arch support, try two or three different ones, switching them between shoes. Most grocery stores have a “Foot Section” where arch supports are sold.

How long does plantar fasciitis take to heal?

The time it takes for plantar fasciitis to heal depends on a lot of factors, the severity of the injury if any, the length of time the pain has been present, the lifestyle of the person with the plantar fasciitis, also, did you get an evaluation form a sports doctor.

Is walking good for plantar fasciits?

While just walking by itself should not injure the plantar fascia, walking alone is not a treatment.

Plantar Fasciitis Treatment, Let me help you

I have a method of treating plantar fasciitis and getting patients better without the need for surgery. Some patients have a physical or structural condition which predisposes them to this kind of injury. Pain, whether it be in the heel, the arch or elsewhere in the foot will keep you from doing the things you want to do. These may be recreational or athletic activities.

Why suffer! Get back to doing the things you like to do without the pain! Come in and get these things checked out by a physician who has experience treating these types of problems. Call for an appointment today.

Most Important Points:

Plantar Fasciitis is very common.

Having flat feet or a high arch can lead to plantar fasciitis.

While stretching can help, treatment usually takes 6 months to one year.

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