What is Plantar Fasciitis?
The plantar fascia is a strong band of ligament that runs between your heel and forefoot. It help support your arch and absorb the stress through your foot when walking. Overuse can damage or cause small tears in the tissue where it inserts into the heel bone leading to inflammation and pain. The cause is unknown but contributing factors include a tight calf muscle, obesity, a high arch, repetitive impact activity, and new or increased activity. A tight calf muscle prevents your ankle from rolling forward normally placing undue strain on the plantar fascia as you walk. A heel spur, if present, is not the cause of pain. The vast majority of people with heel spurs have no pain.
What are the Symptoms?
Pain under the heel. The pain is generally worse with activity, worse when standing up in the morning or with activity after rest.
What is the Treatment?
In most people the condition will resolve with time, activity modification, anti-inflammatory medication, exercises or orthotics. Night splints may be beneficial. A cortisone injection often provides lasting relief. If a tear is present a CAM boot (“moon boot”) may be required.
In the rare cases that do not respond to the above measures surgery can be considered. A person with a tight calf muscle may benefit from endoscopic gastrocnemius recession. If the calf is not tight plantar fascia release from the heel bone is an option.