Plantar Fasciitis

What Is It
Plantar fasciitis is characterized by plantar heel pain. The pain can occur with your first step in the morning or after a long period of rest. The pain is localized to the arch and plantar heel.  It can be unilateral or bilateral. 

Risk Factors

Risk factors include having flat feet, high arches, being overweight, achilles tightness, overuse, too rapid increase in physical activity, poorly cushioned shoe gear as well as inappropriate shoe gear. 

Diagnosis

Typically patients describe intense and acute heel pain localized to the insertion of the plantar fascia on the heel bone (calcaneus). The pain occurs for many with their fist steps in the morning or after a period of rest. It can also occur after extensive walking or standing.  For athletes, the pain can occur after a period of activity/training, it may decline with warm up than reoccur at the end of training.  On exam, pain will be elicited with palpation of both the medial tubercle of the calcaneus and proximal portion of the plantar fascia.  Radiographs are usually taken on your first visit. MRI or other diagnostic testing are not commonly needed, unless your symptoms persist despite proper treatment. 

Treatment

Typically, conservative treatment is very effective and surgical intervention is rarely required. Conservative treatment includes but not limited to cortisone injections, orthotics, and stretching. Some patients may require physical therapy with ASTYM and/or dry needling.  If conservative treatment fails, than PRP and/or Amniotic injections may be considered. Your doctor may also order an MRI to confirm the diagnosis and make sure there is no other cause of your heel pain. If these treatments fail, than surgical intervention is likely required. 

Stretching Examples:

Recommended Over-The-Counter Insoles:

Author
Dr. Mustafa Foot and Ankle Surgeon

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