CONDITION: Plantar Fasciitis

DESCRIPTION:

Definition of plantar fasciitis: Plantar fasciitis is an inflammation of the plantar fascia, a thin layer of tough tissue supporting the arch of the foot that runs from the heel to the base of the toes. It looks sort of like a series of fat rubber bands, but the plantar fascia is made of collagen which is more rigid and non-stretchy. Repeated microscopic tears of the plantar fascia cause pain that is most notable in the morning after getting out of bed. Putting weight on the injured area after periods of rest (such as sleep) will cause stress on the area and a more sudden, aching pain. Plantar fasciitis may also be called “heel spurs,” but this is not always accurate because bony growths on the heel may or may not be involved.

Plantar fasciitis (piriformis) in runners: Do you realize how often your foot strikes the ground? In a Runner’s World article, “A runner’s foot hits the ground about 1,500 times per mile, and the heel and its attaching tissues bear the brunt of that force.” Furthermore, “Drastic or sudden increases in mileage, poor foot structure, and inappropriate running shoes can overload the plantar fascia, the connective tissue that runs from the heel to the base of the toes.”  At Caring Medical, we often see runners with plantar fasciitis who may have increased their mileage too quickly, run on hard surfaces (like the streets of Chicago), ran in old shoes, overpronate, and/or run on a sloped surface (such as streets with gutters.)

Development of plantar fasciitis in runners.
The plantar fascia is a layer of ligamentous connective tissue that runs from the heel bone to the ball of the foot. It not only maintains the arch of the foot, it is also one of the major transmitters of weight across the foot as we walk or run. The stress placed on the plantar fascia is tremendous, and when inflammation occurs it can be quite painful. The inflammation can result from excessive stretching, too much pressure or trauma. If the plantar fascia becomes partially detached at the heel, a heel spur results. A number of possible causes, often working in combination, result in plantar fasciitis. They include tightness of the foot and calf, improper athletic training, stress on the arch or weakness of the foot. Shoes that don’t fit, running on hard surfaces, or overuse (running too fast, too far, too soon) may also be involved. People with low arches, flat feet or high arches are at an increased risk of developing plantar fasciitis. We not only see cases of plantar fasciitis in runners (distance and sprinters), but also in sports that involve running such as tennis, soccer, football, etc.

What are the symptoms of plantar fasciitis?
At Caring Medical, we find that symptoms of plantar fasciitis can occur either suddenly or gradually. When they occur suddenly, intense heel pain on taking the first morning steps or after sitting a long time, known as first-step pain, is usually involved. The foot tries to heal itself in a contracted position while the person is sleeping or sitting. Although this heel pain often subsides as the individual begins to walk around, it may return in the late afternoon or evening. When symptoms occur gradually, a more chronic form of heel pain causes individuals to shorten their stride while running or walking. Individuals may also shift their weight toward the front of the foot, away from the heel.