Treating Plantar Fasciitis
The plantar fascia is the thick band of tissue that makes up the arch of the foot by connecting the heel bone to the toes. When this band becomes overused and stretched, it becomes inflamed. This inflammation is referred to as plantar fasciitis and results in pain.
Several conservative treatment options exist.
Rest: if possible, rest the area and avoid overuse.
Proper Footwear: Since the plantar fascia makes up the arch of the foot, supporting this arch will keep the plantar fascia from overstretching. A proper shoe has a secure closure such as lace or hook and loop, and maintains the arch and a normal alignment of the foot. If plantar fasciitis is a result of poor foot biomechanics, such as fallen arches or excessively high arches, over the counter or custom made insoles may also be necessary to maintain proper foot alignment. Many patients find that wearing shoes with a heel lift or a higher heel helps alleviate pain of the plantar fascia. Higher heeled shoes place the calf muscle on slack, so the plantar fascia is not being pulled
Stretching Exercises: Stretching the heel and calf muscle is very important. Tight calf muscles can lead to an overstretched plantar fascia. Exercises may include reaching for the toes with straight legs, or wall lunges with a straight back leg while the foot remains flat on the floor.
Cold Therapy: During the first few days of plantar fasciitis, this injury will respond well to cold therapy. Applying ice packs or cold therapy to the affected area for 10-15 minutes will decrease the swelling. Ice treatments should focus at the source of pain, usually at the heel where the plantar fascia inserts.
Anti-inflammatory medications: Ibuprofen or Naproxen can decrease the inflammation in the tissues.
Other treatment measures may include:
Lifting The Heel: Wearing a heel cup, shoe lifts under the heel, or a higher heeled shoe places the plantar fascia in a position to protect from over-stretching. Lifting the heel may help the condition, but it is not a permanent fix. Stretching tight calf muscles to increase the flexibility of the heel will be a more permanent fix. If stretching doesn’t work, custom orthotics may be a next step.
Night Splints: When this condition persists, night splints can help to stretch the calf muscle and heel. Night splints place the calf on stretch by lifting the toes and preventing plantar flexion (a pointed toe position).
Boot Cast/Walking Boot: Occasionally patients will revert to a removable walking boot for several weeks.
Injections: Instances occur where patients need more aggressive approaches to treating this condition. Steroid injections to the plantar fascia may be beneficial in these instances.
Surgical Release: When conservative methods fail, surgery to release the plantar fascia are often a last resort.
Conservative treatment methods are usually effective, but it can take several months to fully recover. After recovering from Plantar Fasciitis, many patients will suffer recurrence. If the patient continues the conservative treatment plan as a preventative measure, this condition is much less likely to reoccur. Maintaining flexibility in the ankle, stretching the heel and calf muscle (preferably in the morning before getting out of bed), wearing proper footwear, maintaining a healthy body weight, and avoiding overuse are great methods of preventing this condition.