By Dr. Scott Colasanti
You wake up in the morning, get out of bed and as soon as you put your weight on your feet… OUCH! It feels as though you have stepped on a nail or a sharp piece of glass.
This condition is most likely plantar fasciitis and it is a condition that I commonly see in my office. So what is plantar fasciitis? The word plantar denotes anything to do with sole of the foot (as example, plantar warts). The word fasciitis can be broken up into ‘fascia’ and ‘itis’. The suffix ‘itis’ means inflammation on any kind (as example tendonitis or gastritis). ‘Fascia’ is a strong fibrous connective tissue that surrounds muscles and other structures in the body.
The plantar fascia is the thick band of connective tissue that spans the bottom of the foot, from the forefoot to the heel. Hence plantar fasciitis is an inflammation of the plantar fascia.
How does plantar fasciitis happen?
During normal gait, our heel strikes the ground first, and as we shift our weight forward we transfer our weight to our mid and forefoot. As this shift from the rear to the forefoot happens, the plantar fascia stretches and helps propel us forward. When we put excessive strain on the foot such as with poor footwear, prolonged standing or walking on hard surfaces, or weight gain to name a few, the plantar fascia becomes irritated and inflamed.
If this condition becomes prolonged, it can lead to heel spurs. This happens because bone has a tendency to deform along the lines of stress that it is subjected to. Therefore the excessive stress and the pulling force on the heel where the plantar fascia attaches can become a bone spur.
As with any health condition, when possible, it is best to get to the root of the problem. Discussing the patient’s history will often reveal things like poor footwear, recent weight gain, or excessive stress on the feet (like running on pavement for example). An examination will reveal biomechanical problems with feet, ankle, knees, hips, or back.
What can be done about plantar fasciitis? After identifying the causes, it is best to remove or reduce the stress when possible. Stretching the plantar fascia, icing, foot exercises are very important. Wearing proper footwear and avoiding going bare foot would also advisable.
Custom foot orthotics are often necessary and very helpful. I discussed the importance of these in previous blog. As far as treatment is concerned, I use therapeutic modalities like ultrasound, electric stimulation and LASER therapy, combined with soft-tissue techniques to help improve the healing and reduce the stress. Finally, a plantar fascitis night splint may also be necessary. This helps keep the plantar fascia in a stretched position at night during sleep, which also promotes healing.
Plantar fasciitis can be quite painful and debilitating so it is best to get it checked out as soon as possible. If you’re experiencing this type of pain, please don’t hesitate to contact us for an appointment 519-258-8544.