In order to shorten the road of recovery and prevent recurrence, an informed approach to injury identification, proper pain management and thoughtful lifestyle modifications is the way out.
Foot Ankle International studied that plantar fasciitis affects more than 1 million people per year. Though plantar fasciitis is a self-limiting condition, two-thirds of the patients seek help from a health care professional.
Have you ever have fear of standing back up after resting from the run you just accomplished 20 minutes ago? Do you hesitate taking your first step early in the morning? You might realize that you walk dependently on the outside edge of the foot to avoid placing pressure on the painful heel/sole of the feet. If you just had a ‘light bulb moment’, you likely have the most common heel pain condition in adults – Plantar Fasciitis.
‘Plantar’ Means Sole Of The Feet, ‘Fasciitis’ Means Inflammation Of The Fascia; That Explains The Sharp And Stabbing Pain You Experience At The Bottom Of Your Foot (Medial Calcaneal Tuberosity), Especially Upon Palpation.
The pain felt on the sole of the feet suggest possible micro-tears at the calcaneal tendon attachment from prolonged standing or running. The pain is particularly acute upon getting up in the morning and after resting from activity.
Plantar fasciitis have a high prevalence especially among adults. Obesity being one of the risk factor, having body mass index greater than 30kg per m2 increases the strain and stress on the fascia. A change on the foot biomechanics (a flat foot, excessive pronation or high foot arches) disrupts the shock absorption ability causing overstress injury to the fascia on the sole. Studies have also found that tightness of the posterior muscles of the lower limb was present in the runners with plantar fasciitis. Another cause of plantar fasciitis depends on the demands of your sport or your occupation, whether a professional runner, military personnel or even lecturers with prolonged running, walking or standing.
The symptoms of plantar fasciitis is often worst at the beginning of an activity after rest, for instance the first step you take after waking up in the morning or standing up after resting from long hours of walking or being on your feet. The heel pain typically improves with activity as it warms up.
Identifying possible risk factors, careful history taking and appropriate physical examination is the key to identifying plantar fasciitis. Radiographic imaging such as X-ray, Ultrasonography or MRI are helpful to rule out other heel and soft tissue pathology. According to Journal of Foot and Ankle Surgery (ACFAS) in 2010, subcalcaneal spurs, also known as, ‘heel spur’ does not support the diagnosis of plantar fasciitis. The study shows that people with heel spurs are also found in athletes without plantar fasciitis.
Plantar fasciitis pain can be disabling. If left untreated, chronic recalcitrant plantar fasciitis can lead to other foot, knee, pelvic, hip and back problems due to the way pain impacts the normal walking pattern.
Plantar fasciitis is predominantly a mechanical pathology however the possibility of possible neurologic, arthritic, traumatic, or other systemic conditions that causes heel pain should not be overlooked as mentioned in the 2010 revision clinical practice guideline by ACFAS.
Through clinical experiences and case study reports, various health care professionals have witness patients with plantar fasciitis to be self-limiting, even though researches only have fair evidence for these conservative treatments.
