How to deal with plantar faciitis

Monday, November 23, 2009 3:00 AM  |  Printer friendly version | E-mail to a friend | Q: I have found out that I have plantar fasciitis. Can you exactly explain what that is?

A: Plantar fasciitis is an inflammation of the plantar fascia. Plantar means bottom of foot; fascia is a type of connective tissue. It means inflammation.

A classic sign of plantar fasciitis is heel pain with the first few steps in the morning. The pain is usually in the front and bottom of the heel, but it actually could be over any portion of the plantar facia.

Plantar fasciitis is a repetitive strain injury involving foot and leg muscles, tendons (the part that connects muscle to bone), ligaments ( connects bone to bone) and the bones they attach to.It is typically characterized by muscle imbalances when one or more flexor muscle/tendons are short/tight and one or more opposing extensor muscles/tendons weak. One side of the muscle is tight and the other side is weak. Example: a tight calf muscle and a weak tibialis anterior muscle (that "little bitty" muscle on the outside of your shin bone)

What happens is:

- Repetitive impact on your feet and legs over time causes your flexor muscles/tendons to become short and tight.

- Repetitive impact on short, tight muscles/ tendons causes micro-tearing at the point where the tendons attach to your heel and toe bones.

- Repetitive micro-tearing at the point of attachments causes progressive scarring of tissue, inflammation and pain.

- Over a period of time, heel spurs and arthritis may develop.

Personally, I have noticed that when my shoes wear out, I start getting tenderness in my heels. Because the shoe still looks good does not mean it still gives you the proper support.

If you just started an exercise program, go too hard, too fast, too soon and you do not stretch properly, your chance of getting plantar fasciitis is a lot greater.

Some basic treatments you could try are:

- Stretch the calf muscles several times a day, especially in the morning and after prolonged sitting.

- Ice after activity. You can freeze a "ribbed" plastic bottle with about three-fourths of water, lay the bottle on a towel and move your foot back and forth over it.

- Stretch the plantar fascia in the morning.

- Rest.

- Lose weight if possible, especially overweight women. Extra weight causes excess tension in the plantar fascia.

- Heel cups can be beneficial. When you get older, the fat you need goes away, and the fat you don't want arrives! Like the fat in your heels that you need goes away.

- Arch support can help, especially if you have flat feet.

My husband had great help at Ralph Baker shoes with a pair of running shoes that were "fitted" for his feet and inserts for his work boots and running shoes. It has helped him tremendously in just one week. As always, check with your doctor, especially when the problem does not go away.