By Richard E Hedrick
Plantar Fasciitis is the inflammation and or micro tearing of the fascial complex on the plantar surface or bottom of the foot. Plantar Fasciitis commonly presents with pain in the affected heel or medial arch of the foot. These types of injuries usually occur due to overuse or faulty bio-mechanics of the ankle foot complex during the gait cycle.
Custom made orthotic inserts have been shown to reduce the incidence of Plantar Fasciitis pain in the short-term. Orthotics help to correct for over pronation and excessive supination of the foot. Custom scans are performed to evaluate the overall structure and pressure distribution of your foot. By utilizing an orthotic to stabilize the foot during the gait cycle we reduce the amount of strain on the fascia and in turn reduce pain.
Many people with plantar fasciitis have high arches and tight achilles tendons. The common intervention to correct for these problems is consistent stretching to combat or counteract tissue hypertonicity. Calf stretching of the gastroc and soleous muscles has proven effective for the treatment of plantar fasciitis. To further aid in the resolution of a tight or irritated plantar fascia, many patients have found some resolution by utilizing a tennis ball to roll out and elongate the fascia.
Plantar Fasciitis pain tends to be greater in the morning hours. When we are not upright or weight-bearing for a lengthy period of time, the Plantar Fascia contracts or shortens. In this shortened state, upon waking, the fascia is more prone to micro tears and irritation. Gently stretching and working to elongate the fascia, with rising, can help to alleviate the pain. In some instances a night splint is prescribed. Splints can help to keep the fascia elongated and so less irritated in the morning hours.
Other common interventions to combat Plantar Fasciitis include deep heating ultrasound therapy to warm the tissue and help improve its elasticity. Graston technique has proven effective to help elongate the tissue, remove adhesion and draw blood into the area. Graston is based on a Chinese acupuncture technique called Guasha. Graston technique utilizes stainless steel tools to create friction and release adheasion in a particular tissue segment.
In some cases, carrying excessive body weight, can alter the bio-mechanics of the gait cycle. Additional body weight can cause excessive wear and tear on the joints and tissues of the low back and extremities. In these scenarios appropriate diet and exercise, managed by a health professional, can help to resolve these problems.
Should all other attempts to resolve Plantar Fasciitis prove unsuccessful, surgery or corticosteroid injections may be indicated. Corticosteroid injections can be helpful in the short- term for pain relief. Unfortunately the fundamental problem is not addressed and therefore recurrence rates can be quite high. There are a number of different options for surgical intervention, each with varying results. Options for surgical intervention include the Topaz procedure, Plantar Fascia release procedure, and ultrasound guided needle fasciotomy. Surgery is typically a last-ditch effort to correct for Plantar Fasciitis. The more invasive surgeries run the risk of nerve damage and infection. Surgery should only be considered after all conservative measures have been exhausted.
If you suspect you may suffer from Plantar Fasciitis, consult your local health professional to discuss your options.
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