It is the inflammation of a thick and tense fibrous tissue located on the sole of the foot that is inserted into the heel bone and unfolds forward to anchor itself at the base of the fingers and is the cause of plantar heel pain, being one of the Most common causes of heel pain.

What is the plantar fascia?

The plantar fascia is the sheath that covers the muscles of the ball of the foot, it extends from the fingers to the heel. It starts at the heel and runs along the entire sole of the foot. It is attached to each of the bones that form the metatarsal eminence (“ball of the foot”). The plantar fascia acts like a rubber band between the heel and the metatarsal eminence and supports the arch of the foot. If the band is short the arch will be high (cavus foot), and if it is too long the arch will flatten and become a flat foot. In the heel, the plantar fascia is covered by a layer of fat that acts as a cushion and has the purpose of cushioning the force that we transmit when walking. Injury to the plantar fascia can cause heel pain.

What causes heel pain?

The most common cause of plantar fasciitis in adults and especially in athletes is the result of excessive and repeated stress on the gastrocnemius, leading to prolonged foot pronation. This, in turn, produces repetitive stretching of the plantar fascia causing inflammation and thickening of the tendon. As the fascia thickens, it loses flexibility and strength.

As a person ages, the plantar fascia loses its elasticity and extensor capacity. Likewise, the fat layer of the heel is thinning which generates a decrease in the absorption of forces when walking. This additional force injures the plantar fascia. Injury to the plantar fascia can cause it to swell, tear, or bruise.

Incidence

It is greater in women than in men with an approximate ratio of 4 to 1. Plantar fasciitis is one of the great enemies of the runner. It also has a correlation with age, since it usually affects people over 40 years of age, and more so if they are obese, have poor shoes and work long hours on their feet.

Symptoms

When the fascia is injured, the pain can spread throughout the plantar vault, but its usual location is the back of the sole of the foot, at the level of the calcaneus, which is the weight-bearing area of ​​the heel and is very sensitive to pressure. It is usually more intense in the morning and after walking for a long period of time and after periods of rest. Most people with plantar fasciitis describe the pain as like a razor or pin poking into the bottom of their foot. Others as if they had a stone in their shoe. At the end of the day, the pain may be replaced by a dull ache that improves with rest.

Diagnosis

It is carried out by the anamnesis and by the findings of the clinical examination.

We will find:

• Rarely is there visible swelling, redness, or other apparent changes in the skin.
• Increased sensitivity at the bottom of the heel.
• When we lift the big toe, we trigger an increase in pain.

Likewise, it is important to take an X-ray to rule out other problems, such as a heel spur.

In our centers they are perfectly equipped to verify the behavior of the foot during dynamics, that is walking or running, since it does not always correspond to what is observed in the static analysis A biomechanical analysis of the gait reveals the behavior of the foot in dynamics and can be of great help to find out the cause of fasciitis.

Treatment of Plantar Fasciitis

At our Center Podomédic we know that treatment is slow, the patient usually takes between 6 months and a year to be fully recovered. But we will recommend combinations of treatments to improve as soon as possible and not relapse.

• Non-steroidal anti-inflammatory drugs (NSAIDs). Corticosteroid injections and local anesthetics can be very effective in resistant cases.
• The maximum should be prescribed repose possible until the pain subsides. If you keep walking you will be continually aggravating the injury and increasing inflammation.
• The application of adhesive strips throughout the length of the plantar fascia can be very effective, especially for acute pain and sports activity. at the beginning it must be applied daily
• The application of ice in the area for 15 to 20 minutes helps reduce pain and inflammation and promotes healing. A small plastic bottle can be filled with water and frozen and rolling the heel and arch of the foot over the bottle for about 20 minutes provides massage, stretching and cooling.
• The exercises of plantar fascia stretches They are an important part of treatment and prevention. For recovery to be quick and effective, we should not settle for treating only pain and inflammation.
• Avoid walking barefoot while symptomatic as it increases the tension of the inflamed area.
• The massage it is also important to relax the fascia. This massage should reach the area of ​​the calves, since the tension in the calves affects the tension of the fascia.
• The plantar fascia is tightened, mainly at its heel insert, which is the place most likely to become inflamed. In order to reduce the tension of the plantar fascia at night, it is advisable to prescribe a night splint to combat pain, and prevent the gastrocnemius and plantar fascia from tightening
• In our workshop we make plantar supports Made to measure with the best case materials, it is undoubtedly a fast and reliable way to deal with this problem.
• Training that can help you:

Some of recommended exercises:

• Towel exercise Put a towel in front of you. With your affected toes try to bring the towel towards you. Increase the resistance with a weight on the end of the towel. Do several reps with breaks in between.

• Massages with the opposite leg Move your painful foot slowly up and down over the shin of the other leg, trying to wrap your fingers around it.

• Stretching Stand at a certain distance from a table, resting your hands on it, bending one knee and the other stretched out. Slowly lean into the table, pressing forward until you feel moderate tension in the calf muscles of the straight leg. Hold this position for 15 seconds. With both heels on the floor, bend the knee of the straight leg until you feel moderate tension in the Achilles tendon and hold for another 15 seconds.