Why is your foot hurting?
You wake up one morning and notice that you have sharp pain in the bottom of your foot. As you make your way to the bathroom to get ready for work, you notice that the pain starts to ease up and eventually goes away. You assume it was a cramp and don’t think about it until the following morning when it happens again. What’s causing your foot to do this? How can you stop it? Are there ways to prevent it?
The thick band of tissue that connects your heel bone to your toes along the bottom of your foot is called the plantar fascia. The plantar fascia is the ligament that supports the arch of your foot and absorbs shock when you’re walking, running or exercising. When it becomes stressed and has too much tension placed on it by repetitive stretching and tearing, it can become inflamed and this is known as plantar fasciitis. Certain things can increase your risk of developing plantar fasciitis. Some of them you don’t have any control over, like being between the age of 40 and 60 (it’s more common among this age range), being flat-footed, having a high arch or having an abnormal walking pattern. Other risk factors are more under your control, such as being overweight (adds extra stress to the plantar fascia), the type of activities you participate in (especially those that include running or jumping exercises) and what type of job you have (those that require you to walk or stand on hard surfaces for long periods of time can cause damage to your plantar fascia). The main symptom of plantar fasciitis is a sharp, stabbing pain in the bottom of your foot near your heel. Typically, this pain is worse when you first wake up in the morning and after longer periods of standing or sitting because the ligament contracts and the pain is the result of you stretching it out. If you exercise, the pain gets worse afterwards.
The treatment for plantar fasciitis involves resting, icing and stretching the area. This can several months to get full relief. Resting the area means avoiding any activities that will aggravate your plantar fascia. Icing the area three to four times a day for 15 to 20 minutes at a time can be helpful in reducing pain and inflammation. Also, applying ice after an activity is beneficial. Gentle stretching exercise can help the plantar fascia to gradually release. It’s important to not only stretch your plantar fascia, but your Achilles tendon and calf muscles because these pull on your foot. Another way to stretch your calf and arch is to wear a splint will you’re sleeping. The splint is designed to keep your foot in a flexed position, which helps to lengthen and stretch the plantar fascia. By wearing it overnight, you help to decrease the pain that you have upon waking. Sometimes, it’ll be key to take over-the-counter anti-inflammatories, such as ibuprofen or naproxen, to decrease the inflammation and pain. Just make sure that these won’t interfere with any of your other medical conditions.
Sometimes, these conservative, at-home approaches don’t work. Some people need to have injections of steroid medication or platelet-rich plasma into the plantar fascia to reduce inflammation. It’s important to note that multiple injections of steroids aren’t recommended because it can weaken the tissue, which increases your chances of having the ligament rupture. For chronic plantar fasciitis, some people try extracorporeal shock wave therapy, which uses sound waves to help stimulate healing. Another option is the Tenex procedure, which is minimally invasive and removes the scar tissue. In severe cases when all other treatment options have failed, some people have surgery to disconnect the plantar fascia from their heel bone. It’s important to treat plantar fasciitis because if you don’t, you can have chronic heel pain that can affect your ability to participate in your normal everyday activities. Also, if you alter the way you walk to reduce the amount of pain in your foot, you can end up with foot, knee, hip or back problems.
The best way to not have to deal with plantar fasciitis is to prevent it. There are several things that you can do to minimize your risk. The first is to wear shoes that provide good arch support and shock absorbency. This means avoiding high heels, flip flops and worn-out athletic shoes. It’s key to maintain a healthy weight. If you’re into sports that place a significant amount of impact on your plantar fascia, like walking or running, consider mixing it up and trying other sports that don’t, such as swimming or bicycling. When you’re done exercising, remember to stretch your calves, Achilles and feet. It can also be helpful to stretch them periodically throughout the day if you spend a great deal of time sitting or standing for work.
Plantar fasciitis isn’t a pleasant thing to experience, but there are ways to make it better and prevent it from occurring. If you have any questions or concerns, please speak with your doctor. If you would like more information, please visit the American Academy of Orthopaedic Surgeons’ Plantar Fasciitis page at https://orthoinfo.aaos.org/en/diseases–conditions/plantar-fasciitis-and-bone-spurs