Plantar Fasciitis

Plantar fasciitis is a disease of the plantar fascia on the foot. People who are overweight and runners are particularly affected.

Plantar Fasciitis

What is plantar fasciitis?

The plantar fascia (aponeurosis plantaris’) is a tendon plate located on the lower side of the foot. It extends from the heel to the front ball of the foot. The plantar fascia has the function of ensuring the longitudinal arch of the foot. At the same time, it counteracts a lowering of the arch of the foot.┬áSee sportingology for Meaning of Cradle Cap in English.

If there is a disease of the plantar fascia, doctors speak of plantar fasciitis. This causes pain in the sole of the foot and in the transition to the heel. Plantar fasciitis is the most common cause of heel pain. Around 10 percent of all people are affected by this foot condition at some point in their lives. The disease occurs more frequently in women than in men. The frequency of plantar fasciitis also depends on the body mass index and the age of the affected person. In addition, approximately 70 percent of all patients suffer from obesity.

Causes

Plantar fasciitis is usually caused by inflammation. However, overloading of the plantar fascia can also be responsible for the disease. The inflammation of the aponeurosis plantaris is caused by the permanent irritation of the tendon plate. Misaligned feet, weak foot muscles or muscular imbalances have a positive effect on the development of plantar fasciitis.

Plantar fasciitis often occurs in runners who suffer from flat feet. Flat feet cause the plantar aponeurosis to be constantly overstretched. This leads to overstimulation and, in the further course, to inflammation of the plantar fascia. A similar thing happens in runners with a pes cavus. Without a longer recovery break there is a risk of suffering from chronic pain.

People with different leg lengths or people who are very overweight are also often affected by plantar fascia. It is not uncommon for the foot disease to also occur in people who have to do standing work for a long time.

Symptoms, Ailments & Signs

Plantar fasciitis becomes noticeable through pain in the middle part of the heel bone. The pain occurs more frequently after getting up in the morning or after longer breaks. Plantar flexion occurs in the foot during rest. The plantar fascia is shortened slightly. If the patient rolls his foot while walking, the plantar aponeurosis expands again. This process, in turn, causes pain.

The pain usually subsides after a short time. However, with prolonged stress on the foot, it can increase again. Plantar fasciitis is unilateral in 70 percent of all patients. In the remaining 30 percent, however, it occurs on both sides. Around 80 percent of all those affected also have tension in the Achilles tendon. In addition, most patients have difficulty bending their foot.

If plantar fasciitis persists for a long period of time, there is a risk of heel spur formation. This is a small bony outgrowth that occurs on the heel bone and points toward the toe.

Diagnosis & course of disease

Plantar fasciitis is usually diagnosed based on its typical symptoms. These include the pressure sensitivity of the soles of the feet and heel pain in the morning hours. Further examination measures are usually only carried out if conservative therapy is unsuccessful or injections are to be made.

X-rays often reveal a heel spur. The same applies to stress fractures or tumors, which can also be a reason for heel pain. Another diagnostic method is sonography (ultrasound examination). It can be used to determine a thickening of the plantar fascia.

Alternatively, examinations such as skeletal scintigraphy or magnetic resonance imaging (MRI) can also be considered. The course of plantar fasciitis is generally positive. The foot problem usually improves after a year. It does not matter which therapy is used.

Complications

If left untreated, plantar fasciitis can become chronic and cause persistent, severe pain. Conservative treatment of the disorder is usually very lengthy and lasts several months, but complications are generally not to be expected. In about every twentieth person affected, conservative therapies do not lead to the desired success – these include in particular shoe inserts and physiotherapy as well as non-steroidal anti-inflammatory drugs to combat the pain.

Then an operation can make sense, even if it is not a common treatment method. The surgery comes with a number of risks. It is therefore possible that the pain after the surgical procedure is stronger than before and spread to the metatarsus. This development is particularly to be feared if the entire plantar fascia was severed during the operation.

If the surgeon injures the tendon plate, a flat foot can develop. In addition, there are a number of nerves in the foot area that can be affected by an operation. This can lead to chronic pain that is worse than the original condition. Even a loss of mobility in one or more toes is not impossible.

As with any operation, general operational risks can also occur. The wound can become inflamed and, in the worst case, lead to sepsis. In addition, painful or unsightly scars may remain. Venous thrombosis resulting from surgery is another possible complication.

When should you go to the doctor?

Since plantar fasciitis does not heal itself, this disease must always be examined and treated by a doctor. Only early diagnosis and treatment can prevent further complications. As a rule, the life expectancy of those affected is not negatively affected by plantar fasciitis.

The doctor should be consulted for plantar fasciitis if the affected person suffers from severe pain in their feet. The pain can also spread to the entire leg and have a very negative effect on the patient’s everyday life. The Achilles tendon is also negatively affected by the disease and can tear. If the pain in the feet occurs over a longer period of time and does not go away on its own, a doctor must be consulted in any case.

Plantar fasciitis is usually treated by an orthopedist or a sports medicine specialist. It cannot generally be predicted whether complete healing will occur.

Treatment & Therapy

There are several options available for treating plantar fasciitis. Physical treatment is considered to be particularly effective. It includes stretching exercises for the plantar fascia and the Achilles tendon. With these measures, an improvement in the symptoms can be achieved after two months. Low-dye taping is also part of physical therapy.

A tape bandage is applied around the foot, which supports the longitudinal arch. This leads to a reduction in pressure on the plantar aponeurosis during running movements. Special foot massages can also be used to relax the muscle fascia and improve blood circulation.

The use of orthoses is also helpful against plantar fasciitis. With this method, the patient receives orthopedic insoles for his shoes. The orthoses counteract overpronation of the foot. At night, the patient can also wear leg braces. These prevent a plantar-fixed foot position.

Pain relievers such as nonsteroidal anti- inflammatory drugs are also given to combat the pain. If conservative therapy is unsuccessful, corticosteroids can be injected into the diseased foot. This method is successful after a short time. However, there is a risk of fat pad loss in the heel. This in turn increases the risk of a plantar fascier tear.

Another treatment option is extracorporeal shock wave therapy. It pursues the goal of stimulating the body to positive inflammation. Only one percent of all patients require an operation after unsuccessful conservative treatment.

Prevention

Runners can prevent plantar fasciitis by paying attention to a balanced and regular training. Stretching and strengthening exercises are also considered helpful. It is also important to avoid being overweight and standing for long periods of time.

Aftercare

In most cases, patients with plantar fasciitis have very few or even no special follow-up measures available. First and foremost, a doctor should be consulted for this disease so that it can be diagnosed early and treatment can be initiated quickly. The sooner a doctor is consulted, the better the further course of the disease.

Plantar fasciitis cannot heal itself. Most of those affected are dependent on taking various medications. A regular intake and also a correct dosage is always to be observed. If anything is unclear or if you have any questions, you should always consult a doctor first. A doctor should also be contacted in the event of side effects.

In many cases, those affected should wear a bandage on their foot to relieve the foot and prevent further discomfort. Foot massages can also be very helpful and significantly alleviate the symptoms. Some of those affected are dependent on their own family for care in their everyday life, although psychological support can also be very helpful in many cases. As a rule, plantar fasciitis does not reduce the life expectancy of the affected person.

You can do that yourself

In the case of plantar fasciitis, there are some self-help measures that can make everyday life easier for those affected and can also accelerate the healing of the disease.

In the case of overweight, this must be reduced, since being overweight promotes plantar fasciitis. The person concerned should pay attention to a healthy diet. Sporting activities should be designed in such a way that they do not put excessive strain on the feet and legs. In general, the lower extremities should no longer be subjected to too much strain. In some cases, inserts can also be worn in shoes to relieve discomfort.

Furthermore, plantar fasciitis is often treated with medication and painkillers. It is important to ensure that it is taken regularly and to avoid possible interactions with other medications. The movement can be increased again with the help of physiotherapy exercises, which can also be carried out at home. Stretching and stretching of the extremities is recommended, although strength exercises can also be helpful. Patients with plantar fasciitis should avoid standing for long periods of time. Regular check-ups with the doctor are also advisable.