Plantar fasciitis is characterized by stiffness and inflammation of the main fascia (fibrous connective [ligament-like] tissue) on the bottom of the foot. It is occasionally associated with a bone
spur on the heel. Occasionally there may be a partial or complete tear of the fascia of the bottom of the foot. Bone spurs themselves usually do not cause symptoms.
Although plantar fasciitis may result from a variety of factors, such as repeat hill workouts and/or tight calves, many sports specialists claim the most common cause for plantar fasciitis is fallen
arches. The theory is that excessive lowering of the arch in flat-footed runners inÂcreases tension in the plantar fascia and overloadÂs the attachment of the plantar fascia on the heel bone (i.e.,
the calcaneus). Over time, the repeated pulling of the plantar fascia associated with excessive arch lowering is thought to lead to chronic pain and inflammation at the plantar fasciaâs attachment
to the heel. In fact, the increased tension on the heel was believed to be so great that it was thought to eventually result in the formation of a heel spur.
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 theyâve 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.
A physical exam performed in the office along with the diagnostic studies as an x-ray. An MRI may also be required to rule out a stress fracture, or a tear of the plantar fascia. These are conditions
that do not normally respond to common plantar fasciitis treatment.
Non Surgical Treatment
The plantar fascia is a band of tissue, much like a tendon, that starts at your heel and goes along the bottom of your foot. It attaches to each one of the bones that form the ball of your foot. The
plantar fascia works like a rubber band between the heel and the ball of your foot to form the arch of your foot. If the band is short, you'll have a high arch, and if it's long, you'll have a low
arch, what some people call flatfeet. A pad of fat in your heel covers the plantar fascia to help absorb the shock of walking. Damage to the plantar fascia can be a cause of heel pain.
Surgery should be reserved for patients who have made every effort to fully participate in conservative treatments, but continue to have pain from plantar fasciitis. Patients should fit the following
criteria. Symptoms for at least 9 months of treatment. Participation in daily treatments (exercises, stretches, etc.). If you fit these criteria, then surgery may be an option in the treatment of
your plantar fasciitis. Unfortunately, surgery for treatment of plantar fasciitis is not as predictable as a surgeon might like. For example, surgeons can reliably predict that patients with severe
knee arthritis will do well after knee replacement surgery about 95% of the time. Those are very good results. Unfortunately, the same is not true of patients with plantar fasciitis.