Plantar Fasciitis or Heel Pain
What Is Plantar Fasciitis?
Heel Pain caused by Plantar Fasciitis is an inflammation of the plantar fascia at its insertion onto the calcaneus, or heel bone. The root cause behind heel pain is equinus, or a tight Achilles’ tendon. With a tight Achilles’ tendon, there is limited ankle joint motion. With limited ankle joint motion, the foot has to work harder, or over-pornate, to produce normal gait. Over pronation, over time, creates an abnormal pull on the plantar fascia, which can become irritated and become very painful.
Some things that aggravate or make plantar fasciitis worse are: bare feet, flip flops and flats. Usually a shoe with a slight heel will relieve the pain.
What are the Symptoms of Plantar Fasciitis?
- Pain at the bottom of the heel
- Pain that is the most intense with the first steps in the morning, or after periods of rest
- Typically, the pain is better after a few minute of walking around
How is Plantar Fasciitis Treated?
For Acute Plantar Fasciitis, the Triad of Treatment is Stretching, Treating the Inflammation, and Splinting the Fascia.
A. Stretching the Achilles’ Tendon
The key to stretching exercises is lengthening the Achilles’ tendon. This allows more motion at the ankle joint, thus relying less on the plantar fascia for normal gait. Equinus, or a tight Achilles’ tendon, is the root cause behind plantar fasciitis.
B. Treating the Inflammation
Inflammation of the plantar fascia is what causes pain. Treating the inflammation can be done with steroid injections, oral steroids, oral NSAIDs, and ice massage.
Note: Please consult a physician before taking any medications.
C. Splinting the Fascia
This is done to help prevent the fascia from flattening out with each step. Each time the fascia flattens out; it pulls off the heel bone, and recreates the pain.
For Chronic Plantar Fasciitis or plantar fasciitis that has occurred longer than 6 months is treated slightly differently:
A. ESWT: Extracorporeal Shockwave Therapy
ESWT is an FDA approved form of treatment. It is a non-surgical approach to pain relief that is used regularly to cure common problems like Chronic Plantar Fasciitis and Chronic Achilles Tendonitis.
The therapy works by targeting shockwaves directly to the area that is experiencing pain. This is a non-invasive procedure that includes 3 weekly sessions that typically last less than 30 minutes per session. Watch a video!
B. PRP Injections: Platelet Rich Plasma
This procedure is done in the Operating Room Suite under local or regional anesthesia. Blood is taken from your arm and the platelets are removed. Your body’s own platelets are then injected back into the plantar fascia. This provides healing potential for CHRONIC PLANTAR FASCIITIS.
C. Stem Cell Therapy
This procedure is also done in the Operating Room Suite. This technique involves the injection of stem cells, with or without Platelet Rich Plasma, into the plantar fascia to treat the stressed connective tissue. These shots can work better than the traditional cortisone shots for CHRONIC PLANTAR FASCIITIS, since they not only soothe the pain, but they regenerate damaged tissue.
D. Plantar Fascial Release
If the above mentioned conservative therapies fail, a surgical release of the plantar fascia may also be performed. An incision is made on the bottom of the foot and the contracted, scarred fascia is released. This can also be performed using an endoscope.