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Plantar
Fasciitis
Definition:
Plantar Fasciitis is a persistent pain located on the
plantar (bottom) of the heel and the medial (inside) of the foot. The plantar
fascia is a fibrous, tendon-like structure that extends the entire length of the
bottom of the foot, beginning at the heel bone and extending to the base of the
toes. During excessive activity the plantar fascia can become irritated,
inflamed and may even tear if the area is subjected to repetitive stress. Heel
contact during the gait cycle exposes a specific area to this stress. This area
is known as the medial-plantar aspect of the heel, where the plantar fascia
attaches to the heel bone.
Symptoms:
The pain resulting from this injury is most noticeable in
the morning when the first few steps are taken and subsides with prolonged
walking. Likewise, during athletic activity the pain will occur in the beginning
of the exercise routine and subsides as activity continues.Causes of Injury:
Plantar Fasciitis is more common in athletes who have a
high-arch, rigid type of foot or a flat, pronated foot. In motion, the plantar
fascia experiences continuous stress and excessive pulling which results in
inflammation and pain.
- A high-arch foot has a tight band-like plantar
fascia that is rigid during the gait cycle.
- The plantar fascia is stretched in the pronated foot
by excessive motion.
- Improper shoe selection can be a cause of the
injury; foot and gait type must be considered.
- Stiff-soled shoes can cause stretching of the
plantar fascia.
- Overworn shoes allow the foot to pronate more
extensively and can result in an injury to the plantar fascia.
- The most common cause is a sudden increase in the
amount or intensity of activity within a short period of time.
Short Term Treatment:
In determining the proper treatment for Plantar Fasciitis
it is important that the athlete knows and eliminates the causative factors of
the injury. A complete medical history analysis, pedal examination, gait
analysis and x-rays to check for a heel spur are recommended.
- Ice application and strapping.
- Complete rest or a reduction in the intensity of
exercise.
- Physical therapy involving whirlpool and ultrasound.
- Treat with the use of anti-inflammatory pain medicines.
The most acceptable over-the-counter medications of this type are Ibuprofen
and Naproxen Sodium and should be taken in the dosages indicated on
the packaging. Prescrition anti-inflammatory medication or
cortisone injections may be necessary to alleviate severe pain in acute cases.
- Taping the foot.
Long Term Treatment:
In cases that are persistent, orthotic devices help
correct biomechanical problems and alleviate stress and strain on the plantar
fascia.
- High arches require softer orthotic devices for
shock absorption.
- Flattened arches require a more rigid orthosis to
control pronation.
- To prevent recurrence, plantar fascia and calf
muscle stretching exercises.
Many patients respond to these forms of treatment; only a
very small percentage of patients require surgery.
Information and graphics provided by
the American Running and Fitness Association.
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