What Causes Heel Discomfort To Appear

Foot Pain

Overview

The plantar fascia is a strong, relatively inflexible, fibrous ligament band that runs through the bottom of the foot. That band helps to keep the complex arch system of the foot, absorb shock, plays a role in body balance and in the various phases of gait. The band transmits your weight across the bottom of the foot with each step you take. When the heel of the trailing leg starts to get off the ground, the band bears tension that is approximately twice the body weight. The tension on the band at this moment is even greater if the calf muscles are not flexible enough.




Causes

Plantar fasciitis occurs because of irritation to the thick ligamentous connective tissue that runs from the heel bone to the ball of the foot. This strong and tight tissue contributes to maintaining the arch of the foot. It is also one of the major transmitters of weight across the foot as you walk or run. Therefore, the stress placed on the this tissue is tremendous.




Symptoms

The symptoms of plantar fasciitis are pain on the bottom of the heel, pain in the arch of the foot, pain that is usually worse upon arising, pain that increases over a period of months. People with plantar fasciitis often describe the pain as worse when they get up in the morning or after they’ve been sitting for long periods of time. After a few minutes of walking the pain decreases, because walking stretches the fascia. For some people the pain subsides but returns after spending long periods of time on their feet.




Diagnosis

If you see a doctor for heel pain, he or she will first ask questions about where you feel the pain. If plantar fasciitis is suspected, the doctor will ask about what activities you've been doing that might be putting you at risk. The doctor will also examine your foot by pressing on it or asking you to flex it to see if that makes the pain worse. If something else might be causing the pain, like a heel spur or a bone fracture, the doctor may order an X-ray to take a look at the bones of your feet. In rare cases, if heel pain doesn't respond to regular treatments, the doctor also might order an MRI scan of your foot. The good news about plantar fasciitis is that it usually goes away after a few months if you do a few simple things like stretching exercises and cutting back on activities that might have caused the problem. Taking over-the-counter medicines can help with pain. It's rare that people need surgery for plantar fasciitis. Doctors only do surgery as a last resort if nothing else eases the pain.




Non Surgical Treatment

If you protect your injured plantar fascia appropriately the injured tissues will heal. Inflammed structures will settle when protected from additional damage, which can help you avoid long-standing degenerative changes. Plantar fasciitis may take from several weeks (through to many months) to heal while we await Mother Nature to form and mature the new scar tissue, which takes at least six weeks. During this time period you should be aiming to optimally remould your scar tissue to prevent a poorly formed scar that may become lumpy or potentially re-tear in the future. It is important to lengthen and orientate your healing scar tissue via massage, gentle stretches, and light active exercises. In most cases, your physiotherapist will identify stiff joints within your foot and ankle complex that they will need to loosen to help you avoid plantar fascia overstress.A sign that you may have a stiff ankle joint can be a limited range of ankle bend during a squat manoeuvre. Your physiotherapist will guide you.

Plantar Fascitis




Surgical Treatment

Surgery is usually not needed for plantar fasciitis. About 95 out of 100 people who have plantar fasciitis are able to relieve heel pain without surgery. Your doctor may consider surgery if non-surgical treatment has not helped and heel pain is restricting your daily activities. Some doctors feel that you should try non-surgical treatment for at least 6 months before you consider surgery. The main types of surgery for plantar fasciitis are Plantar fascia release. This procedure involves cutting part of the plantar fascia ligament . This releases the tension on the ligament and relieves inflammation . Other procedures, such as removing a heel spur or stretching or loosening specific foot nerves. These surgeries are usually done in combination with plantar fascia release when there is lasting heel pain and another heel problem. Experts in the past thought that heel spurs caused plantar fasciitis. Now experts generally believe that heel spurs are the result, not the cause, of plantar fasciitis. Many people with large heel spurs never have heel pain or plantar fasciitis. So surgery to remove heel spurs is rarely done.




Stretching Exercises

Stretching exercises for the Achilles tendon and plantar fascia are recommend to relieve pain and aid in the healing process. Sometimes application of athletic tape is recommended. In moderate or severe cases of plantar fasciitis, your doctor may recommend you wearing a night splint, which will stretch the arch of your foot and calf while you sleep. This helps to lengthen the Achilles tendon and plantar fascia for symptom relief. Depending on the severity of your plantar fasciitis, your physician may prescribe a store-bought orthotic (arch support) or custom-fitted orthotic to help distribute your foot pressure more evenly.

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