Plantar fasciitis is an irritation or inflammation of the plantar fascia, or fibrous band on the sole of the foot that extends from the bottom of the heel bone (calcaneus) to the base of the toes. It acts as a thick rubber band on the bottom arch of the foot. The inflammation results from mechanical strain (traumatic fasciitis) or from abnormalities of foot structure (biomechanical plantar fasciitis).
Pain may occur along the entire course of the plantar fascia because of microtears along that band. It may be inflamed at the point of attachment into the calcaneus, or along the inside edge of the arch (medial band plantar fascia), middle of arch (central band), or outer edge of the arch (lateral band).
The condition is most common in runners and other athletes or people whose job requires prolonged walking or standing. The condition is also seen in those who have put on weight, either by dietary habits or pregnancy.
In this type of the condition, the pain may resolve with the loss of weight. Some cases of plantar fasciitis are attributable to abnormal pronation (inward roll of foot in motion). Plantar fasciitis is
the most common cause of heel and arch pain. Plantar fasciitis is common in both men and women;
- Most individual (76%) are between 40-70 years of age.
- Most cases involve only one foot, however, both feet can be affected.
- Resolution of chronic fasciitis takes about 6 months for 75% with conservative care.
Plantar fasciitis usually responds to conservative treatment (nonsurgical). Treatment may consist of ice packs, stretching exercises, heel pads or cups, over-the-counter arch supports, prescription arch supports (orthotics), physical therapy, anti-inflammatory medication, injections (corticosteroid), foot taping, night splints, or walking boot. Weight loss is a consideration if the patient is obese.
Although conservative treatment is effective, It can likely take several weeks or even months for resolution of symptoms. Some type of shoe insert (heel cup, arch support or orthotic) is usually necessary after treatment to prevent recurrence. Symptoms that have not responded after a lengthy period of conservative treatment may require surgical intervention
Individuals may be referred for physical therapy for restoration of muscle flexibility and strengthening. A common cause of fasciitis is tight calf muscles. Muscle strengthening addresses any strength imbalances that may contribute to this condition.
Orthotics (custom shoe inserts) help normalize walking and running by placing the foot in a neutral position. Individuals with exceptionally high arches would require a support with a cushioned arch.
Those with extreme flatfoot may require a semi-rigid or rigid device which provides a more present arch.