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Plantar Fasciitis

Plantar Fasciitis is the result of inflammation of the Plantar Aponeurosis (a dense ligamentous tissue), which stretches from the bottom of the heel bone to base of the toes (balls of feet). This condition is usually indicative of a biomechanical pathology such as flat or high arched feet.

The most common region of the fascia to be affected is at the bottom of the heel bone (origin). Poor biomechanics cause constant pulling and tearing of the ligament from the bone. The result is a continual inflammatory response. A common structural defence is increased calcium deposition at the heel bone, known as a heel spur. The spur itself rarely causes pain. It is the tearing and inflammation of the ligament that creates the discomfort.

The most common symptom is heel pain, usually much worse when standing in the morning as your feet bear your entire weight. The immune system attempts to repair the damage while you are off your feet thus creating the painful inflammation.

When you stand, you put pressure on the inflamed area, which compresses the nerve fibres. After several steps the pain subsides substantially. This process will usually repeat several times through the day following moderate to long periods off your feet.

Treatment:

  1. The use of non-steroidal anti-inflammatory medications, NSAIDS to relieve acute inflammation and pain. Applying ice packs to the area also help. Occasionally, injectable corticosteroids are used to reduce the inflammation. These injections are contraindicated if using shock wave therapy. Shock wave therapy is the best alternative.
  2. Correction of the causative biomechanical problem with functional corrective orthotics. To avoid substandard imitations and insurance fraud, please review our articles on biomechanics and orthotics.
  3. Extra Corporeal Shock Wave Therapy is particularly useful due to its pain reduction properties. The long-term effects of this therapy are extremely successful at treating stubborn, unresponsive plantar fasciitis. Shock wave therapy reduces inflammation, helps to break up fibrous adhesions, and stimulates the production of new blood and lymph vessels in the injured area.
  4. Stretching and resistance exercises will help the foot’s weakened intrinsic muscles to strengthen.

These exercises are successful when the causative muscle imbalance and mechanical misalignments are corrected through orthotic management.