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The Examination Room:
Plantar Fasciitis

Plantar Fasciitis is the most common cause of localized heel pain and is the most common problem seen in medical practices today. It is typically caused by a biomechanical imbalance resulting in tension along the plantar fascia. This strain causes inflammation of the plantar fascia, a ligament structure that supports the arch of the foot. The plantar fascia is the thick connective tissue that runs from the heel bone to the ball of the foot. When this ligament stretches beyond its normal capacity, the soft tissue draws closer to the heel bone which leads to inflammation and heel pain.

“Plantar Fasciitis is the most common cause
of localized heel pain…”

The body’s tendons, ligaments and muscles start to lose the normal elasticity and resilience during the course of aging, making them more prone to strain during normal daily activities. In active young and middle aged adults, plantar fasciitis is typically caused from activities such as running, walking or even jumping on hard surfaces. Athletes and soldiers are often affected by plantar fasciitis as they spend a considerable amount of time on their feet. Plantar fasciitis is also influenced by the mechanics of the foot. Conditions such as flat feet, high arches, pronation or having an abnormal gait (the way in which the foot hits the ground), can cause the fascia tissue to become overworked or stretched abnormally resulting in tears and inflammation. Other contributing factors include inward twisting of the ankle and obesity.

The position of the feet and ankles in sleep promotes cramping of the fascia and calf muscles. Under the weight of a blanket the plantar fascia contracts with the pointing of ones feet. Most sufferers will feel morning pain because the fascia ligament tightens up during the night while sleeping, causing pain to diminish. However, when climbing out of bed pressure is placed on this ligament and it becomes taut and pain is particularly acute. Pain usually decreases as the tissue warms up, but may easily return again after long periods of standing or weight bearing, physical activity or after getting up after lethargy or sitting down.

Symptoms Include:

  • Tightness in the Achilles tendon
  • Pain that worsens when climbing stairs or standing on the toes
  • Noticeable discomfort after long periods of standing or walking
  • Tenderness or throbbing that lessens with activity but returns during rest
  • Stiffness and hurting in the morning or after resting that gets better after a few steps but gets worse as the day progresses

“The most effective treatment commonly
involves the use or combination of night
splints…”

Prescribed treatment of most plantar fasciitis cases can be remedied with relatively simple conservative methods or a combination of the following; rest, ice, stretching, stregthening, night splints, supports, heel cups, orthotics and anti-inflammatory agents. The most effective treatment commonly involves the use or combination of night splints, which have been proven to speed healing and reduce the associated heel pain and inflammation from plantar fasciitis. In general, plantar fasciitis is a self-limited condition. Symptoms will resolve quicker when the interval between the onset of symptoms and treatment is shorter. Usually, plantar fasciitis can be treated successfully by tailoring treatment to an individual’s risk factors and preferences.

DME Treatment Analysis:

  • Night Splints are designed to comfortably position the foot in a controlled amount of dorsiflexion to provide a gentle stretch to the plantar fascia and Achilles tendon. This gentle stretch helps reduce the muscle contracture, inflammation and associated heel pain and helps promote healing of plantar fasciitis.
  • The AirHeel, by Aircast, is a Plantar Fasciitis Support. Specifically designed to treat plantar fasciitis, Achilles tendonitis, and heel pain. Using two interconnected aircells located under the foot arch and in back of the heel, the AirHeel applies pulsating compression with every step to help reduce swelling and discomfort, and enhance circulation. It’s made of lightweight breathable fabric and is simple to apply, just slip it on like a sock and adjust the fit with one strap.
  • The Plantar Fasciitis Support, by Bledsoe, provides continuous elastic tension and pressure to reduce the pain associated with inflammation due to plantar fasciitis. It effectively reduces pain, allowing patients to strengthen the muscles of the foot, arch and lower leg as well as stretch the Achilles tendon to provide relief and prevent future discomfort from plantar fasciitis. The strap maintains tension continuously during use reducing painful inflammation while exercising the calf and foot muscles.
  • Heel Cups reduce heel pressure, absorb shock and relieve pain. The blue spot is a softer durometer profile for enhanced comfort. The shape of the cushion and medial position of the soft, blue spot help relieve pressure and pain on the most sensitive area of the plantar fascia.

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