It usually starts out as a nagging bite on the bottom of your heel during a run or a workout. Is there a pebble in your shoe? You tell yourself that maybe it won’t be there next time. But then it starts to hurt when you get out of bed in the morning. You feel pain every time you walk or stand. It is now almost impossible to run normally and the thought of jumping is cringe worthy.
You may be experiencing plantar fasciitis, commonly called a heel spur. Technically it is the inflammation of the muscle and tendon on the bottom of the foot. The plantar fascia is a thick band of connective tissue that runs from the front of the heel bone to the ball of the foot and acts to support the arch of the foot. When this inflames, it is called plantar fasciitis.
Causes of Plantar Fasciitis
When the foot is on the ground the full weight of the body is concentrated on the plantar fascia. This force stretches the plantar fascia as the arch of the foot tries to flatten from the weight of your body. The force increases with walking, running, or jumping. This leads to stress on the plantar fascia where it attaches to the heel bone. Small tears of the fascia can result and scar tissue is formed causing increased tightness in the plantar fascia. The scar tissue along with the increased tightness leads to chronic inflammation and pain. If you have “flat feet” and over pronate this will put more stress on the tissue and cause repetitive injury to the plantar fascia.
Symptoms of Plantar Fasciitis
The symptoms of plantar fasciitis include pain along the arch of the foot, and can be more concentrated towards the heel of the foot. The pain is worse when weight is placed on the foot. This is usually most pronounced in the morning when the foot is first placed on the floor. Prolonged standing can also increase the painful symptoms. It may feel better after activity but most patients report increased pain by the end of the day. Pressing on this part of the heel causes tenderness. Pulling the toes back toward the face can be very painful.
Diagnosis
If you have one of these symptoms, visit Bryn Mawr Wellness, to have your foot examined. Since there are several conditions that can cause heel pain, plantar fasciitis must be distinguished from these conditions. Diagnosis of plantar fasciitis is generally made during the history intake and physical examination. We can thoroughly examine your foot and in some cases, your gait to determine how the foot distributes your weight and pressure to see if you over pronate (flat feet) or over-supinate (high arches). Either of these findings, in combination with some faulty biomechanics, can predispose people to having plantar fasciitis. At Bryn Mawr Wellness, we can not only treat your heel pain, but give you exercises and shoe recommendations so that it does not return.
Treatment of Plantar Fasciitis
We use a multi-disciplinary approach to treating plantar fasciitis at Bryn Mawr Wellness. We combine Active Release Techniques and the Graston Technique to break up the scar tissue formed during the injury and help decrease the inflammation. Often we discuss proper footwear and the option of orthotics to help stabilize the arch of the foot. Patients with plantar fasciitis will also be provided with stretches and exercises to strengthen the foot and prevent further injury.