You may not have known the fancy name—plantar fasciitis—but you certainly know about the pain. You swing your legs out of bed in the morning, stand up, and—ouch! That stabbing ache under your heel or midfoot has you sitting down again in a hurry. This symptom is typical of people with damage to the plantar fascia, a ligament that runs along the bottom of your foot.
Form and Function
From underneath, the ligament looks something like a plant trellis—thicker where it attaches to the heel, and spread out into sections where it attaches to the toe bones. Its function is to hold the bones in place to form your arch. This structure allows your foot to flex slightly to absorb the impact of each step. When all works as it should, there is no pain. Overuse can weaken the ligament over time, however, allowing it to stretch, develop small tears, or rupture completely. A weakened or torn ligament can become inflamed and swollen. When it presses on other foot tissues, pain is often the result.
Middle-aged people often sustain these injuries because of wear and tear over time. They are also common in athletes, people who stand or walk a lot at work, or even those who are pregnant or gain weight suddenly. Your risk of developing injuries also increases if you have flatfoot, cavus foot, tight Achilles tendons or calf muscles, and pronation problems (ankles roll inward too far when you walk). Poorly fitted or worn out shoes can even contribute to the problem.
How Do I Know If I Have Plantar Fasciitis?
Other conditions can also cause heel or midfoot pain, so it is always a good idea to get a professional diagnosis for any foot pain. We will check your feet, including how they move as you walk. Sharing your history of past injuries, when and how badly your feet hurt, and your common activities will give us clues as well. A tell-tale symptom is pain after rest (at night or after sitting or inactivity) that gets better as you move about and limber up the ligament.
Imaging tests are usually not needed for diagnosis unless they are used to rule out another problem like a fracture or pinched nerve. Don’t ignore this problem just because the pain goes away with movement. Chronic plantar fasciitis can begin altering your gait to alleviate the pain, which can cause further problems in your legs, hips and back.
Healing Treatments for Heel Pain
Many conservative treatments relieve pain. We may recommend a pain relief medication, a temporary relief while you search for other ways of healing. Physical therapy can be very helpful for stretching out the ligament, your Achilles tendon, and calf muscles. Strengthening exercises for your lower legs can stabilize your ankles and feet reduce further damage to the plantar fascia. We can prescribe night splints that keep the calf and arch stretched while you sleep, or create custom orthotics to redistribute your weight more evenly over your feet to reduce strain. Steroid injections for severe pain and shock wave therapy to stimulate healing have also been used to some effect. Recent reports have indicated some hope for the use of amniotic tissue to promote healing. As a last resort, surgery is possible, but detaching the ligament will make your arch weaker yet.
Mark Gasparini, D.P.M., has the expertise to help you find the solution to plantar fasciitis and all your other foot problems. Call us at (516) 804-9038 and set up a consultation at our office in Massapequa, NY. We will help you find relief from your pain.