AthletePlus - Springdale, Arkansas - Athlete Plus - Physical Therapy - Sports Training - Athlete Plus - Speed Training - AthletesPlus - Core Training
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AthletePlus - Springdale, Arkansas - Athlete Plus - Physical Therapy - Sports Training - Athlete Plus - Speed Training - AthletesPlus - Core Training |
Phone: 479-751-THER (8437) |
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| The Arch of My Foot Hurts. Is it Plantar Fasciitis? Over 2 million people have this condition. 
A thorough physical therapy evaluation following a visit to your physician is vital for successful treatment.
Many physical therapy treatments have shown success and surgery is the last option.
There are many causes of plantar fasciitis listed below. |
What is plantar fasciitis? The term "-itis" usually means inflammation. Arthritis meaning inflammation of the joint. A recent study however showed that histologic findings are presented to support the thesis that "plantar fasciitis" is a degenerative fasciosis without inflammation, not a fasciitis. (1) As many as 2 million people a year suffer from plantar fasciitis. (2) What causes plantar fasciitis? Plantar fasciitis is caused by straining the ligament that supports your arch. Repeated strain can cause tiny tears in the ligament. These can lead to pain and swelling. This is more likely to happen if: Your feet roll inward too much when you walk (excessive pronation). You have high arches or flat feet. You walk, stand, or run for long periods of time, especially on hard surfaces. You are overweight. You wear shoes that don't fit well or are worn out. You have tight Achilles tendons or calf muscles. (3) |
Symptoms: Pain at arch of foot and very painful when step down out of bed. Due to a concept known as physicological creep, the tissue tightens down while you are sleeping. It may hurt more with certain shoes or as the day goes on. Going up and down stairs can cause pain. A diagnosis of plantar fasciitis is based on the patient's history and physical findings. The accuracy of radiologic studies in diagnosing plantar heel pain is unknown. (4) Treatment: A thorough physical therapy evaluation of the foot would begin treatment. The biomechanics of how the person will be analyzed along with arch height and other possible causes of the pain. We have listed treatments below that have been used with success. There is more information with recent research following that. Custom orthotics Night splints Ultrasound Hands On Manual therapy Stretching program Strengthening the foot intrinsics or small muscles of the foot and toes Cryotherapy - ice or use coke bottle or coke can from fridge. Roll your arch across it for 5 minutes at a time. This is like an ice massage. Taping - kinesiotaping Iontophoresis - Use of acetic acid has shown benefits (5) New shoes Three broad categories are used for treatment: reducing pain and inflammation, reducing tissue stress to a tolerable level, and restoring muscle strength and flexibility of involved tissues.(6) A recent study supports the use of the tissue-specific plantar fascia-stretching protocol using ankle and MTP joint dorsiflexion with long term benefits of return to functional activities. (2,7,8) A survey of the American Academy of Podiatric Sports Medicine in 2007 reported that for early-stage plantar heel pain syndrome they generally recommend avoidance of wearing flat shoes and walking barefoot (92%), use of over-the-counter arch supports and heel cushions (90%), regular stretching of the calf muscles (88%), cryotherapy applied directly to the affected part of the foot (67%), and nonsteroidal anti-inflammatory drug therapy (60%). (1) One study in 2003 suggested that treatment regimens such as serial corticosteroid injections into the plantar fascia should be reevaluated in the absence of inflammation and in light of their potential to induce plantar fascial rupture. (1) Six treatments of acetic acid iontophoresis combined with taping gave greater relief from stiffness symptoms than, and equivalent relief from pain symptoms to, treatment with dexamethasone/taping. (5) Also, foot orthoses and anterior night splints were effective both short-term and long-term in treating pain from plantar fasciitis. (3) Will I need surgery? Nonsurgical management of plantar fasciitis is successful in approximately 90% of patients. Surgical treatment is considered in only a small subset of patients with persistent, severe symptoms refractory to nonsurgical intervention for at least 6 to 12 months. (6) Some studies say there is limited evidence to support surgery. (6) Do I need to stop participating in sports or athletic activities? If the pain is occurring during your sports activity, you need to stop and get assessed by your doctor or physical therapist. If you only have pain after your activity, then you need to reduce your activity or change to non weight bearing such as a bike. |
| REFERENCES: 2. J Am Podiatr Med Assoc. 2007 Jan-Feb;97(1):68-74. Current approaches to the management of plantar heel pain syndrome, including the role of injectable corticosteroids. Pribut SM. 2 not. J Bone Joint Surg Am. 2006 Aug;88(8):1775-81. Links Plantar fascia-specific stretching exercise improves outcomes in patients with chronic plantar fasciitis. A prospective clinical trial with two-year follow-up. Digiovanni BF, Nawoczenski DA, Malay DP, Graci PA, Williams TT, Wilding GE, Baumhauer JF. 3 not. Foot Ankle Int. 2006 Aug;27(8):606-11. Foot orthoses for the treatment of plantar fasciitis. Roos E, Engström M, Söderberg B. 6. Orthop Sports Phys Ther. 1999 Dec;29(12):756-60. Comment in: J Orthop Sports Phys Ther. 2000 Apr;30(4):217. Plantar fasciitis: etiology and treatment.Cornwall MW, McPoil TG. 4. Am Fam Physician. 2005 Dec 1;72(11):2237-42. Plantar fasciitis: evidence-based review of diagnosis and therapy. Cole C, Seto C, Gazewood J. 6.not J Am Acad Orthop Surg. 2008 Jun;16(6):338-46. Plantar fasciitis: evaluation and treatment. Neufeld SK, Cerrato R. 7. Foot Ankle Int. 2007 Jul;28(7):815-22. The influence of foot position on stretching of the plantar fascia. Flanigan RM, Nawoczenski DA, Chen L, Wu H, DiGiovanni BF. 8. J Bone Joint Surg Am. 2006 Aug;88(8):1775-81. Plantar fascia-specific stretching exercise improves outcomes in patients with chronic plantar fasciitis. A prospective clinical trial with two-year follow-up. Digiovanni BF, Nawoczenski DA, Malay DP, Graci PA, Williams TT, Wilding GE, Baumhauer JF. 9. J Am Podiatr Med Assoc. 2003 May-Jun;93(3):234-7. Plantar fasciitis: a degenerative process (fasciosis) without inflammation. Lemont H, Ammirati KM, Usen N. 10. Br J Sports Med. 2006 Jun;40(6):545-9; discussion 549. Epub 2006.Treatment of plantar fasciitis by LowDye taping and iontophoresis: short term results of a double blinded, randomised, placebo controlled clinical trial of dexamethasone and acetic acid. Osborne HR, Allison GT. 11. Healthwise Author: Shannon Erstad, MBA/MPH Medical Review: William M. Green, MD - Emergency Medicine Adam Husney, MD - Family Medicine Barry L. Scurran, DPM - Podiatric Surgery Last Updated: 07/23/2007© 1995-2007, Healthwise, Incorporated Article Date: November 2008 |
So what should you do? See your doctor or local physical therapist when you start getting symptoms. The chronic cases are harder to treat successfully, so get treatment early. |
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