Plantar Fasciitis
What is Plantar Fasciitis?
The name plantar fasciitis tells us where and what the problem is. Plantar refers to the sole of the foot and fasciitis is inflammation of fascia. Fascia is the connective tissue surrounding muscles, nerves and blood vessels (the clearish film we pull off of the chicken breast before cooking it). When these terms are used together we get inflamed fascia on the bottom of the foot. The fascia in question spans from the heel to the toes and helps to support foot structure and function. Plantar fascia is like a thick plastic just beneath the skin on the bottom of the foot. In normal individuals it measures about 3.8 mm and in individuals with symptoms that thickness can increase to 5.7 mm.
What Causes Plantar Fasciitis?
Physical causes:
Several physical and/or mechanical factors may play a role in an individual developing plantar fasciitis. Some of those include:
- Sedentary lifestyle/obesity
- Walking or standing on hard surface for extended time periods
- Running long distances
- Flat feet, high arches or poor foot and/or ankle biomechanics
- Wearing high heels
Medical cause:
- Stress on the plantar fascia
- Small tears in the plantar fascia
- Heel spur (a bony growth off of the front of the heel bone)
What are the Symptoms of Plantar Fasciitis?
Plantar fasciitis typically presents as pain on the bottom of the foot. Most people report this pain as being worse first thing out of bed in the morning or when standing after being seated for a long period of time. This symptom generally lessens in severity with activity over time, but starts back up again after periods of time of inactivity, however overactivity could make it worse (ex: running long distances).
Potentially, the pain of plantar fasciitis can happen anywhere along the course of the plantar fascia. Typically, the pain is localized to the area in the front of the heel bone called the medial calcaneal tubercle and in some cases the pain may radiate from that point towards the toes. Heel walking and pushing off with the toes is likely to make the pain worse.
How to Prevent Plantar Fasciitis?
Plantar fasciitis prevention plans should take a multifactorial approach.
- Wear shoes with good support and cushion
- Replace shoes often if running or walking for long periods on hard surfaces
- Stretch the legs, ankles and feet daily
- Maintain a healthy lifestyle that includes moderate exercise and weight management
- Self-massage on feet after activities
- Perfrom low-impact exercises such as swimming or biking
- Avoid wearing high heels
Plantar Fasciitis Prevention Pathway
Ergonomic Hygiene
The art and science of adapting your physical workspace and surroundings to function best with your specific needs.
Ergonomic Hygiene
Proper posture, position and motion are critical to prevention. It impossible to achieve any of these without the proper workstation setup and healthy mobility.
Mobility Health
The practice of performing mobilization and exercises to maintain proper functioning of the musculoskeletal system (joints, muscles and everything connecting them).
Mobilization
Warm-ups, stretches and strengthening exercises specifically designed to address risks to your mobility health from your environment (work and home).
Rest
Injury and strain due to fatigue is very common and avoidable with proper rest intervals. Microbreaks during activities decrease injury risks.
Rest
It doesn’t take a lot of downtime to allow your body to recover and reset. Depending on the activity rest may just be one minute for every twenty minutes of activity.
How is Plantar Fasciitis Treated?
Conservative treatment is considered first in most cases of plantar fasciitis. This can include night splints, OTC anti-inflammatory medications, manual soft-tissue therapy, physical rehabilitation and corticosteroid injections. Severe cases or cases that do not respond favorably to conservative treatment, or in cases of anatomic variants surgery may be required.
The True Costs of Plantar Fasciitis?
- To You: direct costs of maximizing insurance deductibles and out of pocket max plus the costs of reduced quality of life, lost productivity due to time away from work, and potential disability.
- To Employers: direct costs of $3,000-$10,000 per case plus the cost of quality, lost productivity, absenteeism, and turnover.
- To the U.S. Economy: direct care costs over $300 billion every year plus the costs of lost productivity and disability.
How Common is Plantar Fasciitis?
FAQs About Plantar Fasciitis
Conservative medical treatment that includes a night splint, anti inflammatory over the counter drugs, prescription pain medicine, cortisone injections and physical rehabilitation can cost $3000 or more.
Surgical intervention may range form $7000 to $10,000 or more.
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