Understanding Plantar Fasciitis

Plantar fascitiis is the most common cause of heel pain, affecting approximately 2 million individuals in the United States each year. Clinical manifestation and diagnosis is well recognized based on physical examination and symptoms. This condition occurs along the long plantar fascia ligament, which is a fibrous tissue that spreads across the bottom of the foot connecting from the calcaleus (heel bone) to the proximal phalanges (toes). This structure takes tremendous stress with each step we take. Repetitive activation or irritation of the fascia can lead to mechanical overload and micro tears.
Risk factors which may predispose one to development of fasciitis include decreased ankle flexibility, improper mechanics of the foot, wearing incorrect shoes, being overweight, repetitive activities such as athletes participating in running and jumping. Other causative factors may include standing workers, sustained repetitive stress, and calcaneal heel spurs.  
Typical presentation is heel pain that has been slowly progressive and most noticeable with the first step in the morning or after being sedentary for extended periods. Pain is often sharp or shooting with each step and a progressive dull ache throughout the day. If signs and symptoms are not clear, further diagnostic modalities or consulting with your health care provider may be warranted.
Conservative treatment is the mainstay for recovery. Recovery times may vary, however it is important to understand and adhere to a regimented treatment protocol to achieve success. Symptoms are often self limiting and resolve in 80-90% of people affected within 10 months. Initial treatment should consist of resting and icing. Icing can be performed by freezing a water bottle, soda can, or Dixie cup and rolling the heel over the cylindrical object. Exercises should include specific plantar fascia stretching multiple times per day (see below). Physical therapy has also become a common option to help guide this process and promote healing. Other treatment options for plantar fasciitis include massage, taping techniques, orthotics, and night splints. For more severe and chronic cases that are unresponsive to conventional treatment, casting, steroid injections, anti-inflammatories, and modalities may be utilized.  Surgery is the last option for those who have failed all other treatment approaches.
Here are some take home points. Do not ignore your foot pain. If your signs and symptoms are consistent with plantar fasciitis, you will likely benefit from conventional treatment which consists of icing the sore heel, stretching and massaging the plantar fascia, maintaining a healthy weight, and using proper shoe wear. Please consult your health care professional to determine proper dosage and appropriateness of suggested exercises.  
   Lindsey Welch is a licensed physical therapist at Strive Physical Therapy and Sports Rehabilitation in Moorestown, NJ. She treats a wide variety of musculoskeletal disorders ranging from orthopedics to generalized low back pain. She holds a Doctorate in Physical Therapy from Thomas Jefferson University and is a certified strength and conditioning specialist through the NSCA.

References:

http://www.plantar-fasciitis.org/. Accessed on December 13, 2009.
Mayo Foundation for Medical Education and Research. Accessed on December 13, 2009. http://zcoilblog.blogspot.com/2009/08/foot-stretches-to-prevent-plantar.html
Sanders, Mary E. On the Floor: Keep Trekking with Healthy Happy Feet: Understanding Plantar Fasciitis. ACSM’s Heath & Fitness Journal. 11(4): 29-32, July/August 2007.
Schippert, David W, DiGiovanni, Benedict F, et al. Recent updates in the management of plantar fascitis. Current Orthopaedic Practice. 20(2):130-135, April 2009.

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• Tip of the Month

  January 2012

  Smart Starbucks and Steakhouse Choices

  Starbucks Choices
  • Peppermint Choc Mocha- 520cals, 20g fat
  • Pumpkin Frappuccino- 420cals, 13g fat
  • Flavored Latte- 360clas, 16g fat
  • Latte- 220cals, 15g fat
  • Coffee w/cream and sugar 180 calories
  • Cappuccino- 120cals, 4g fat
  • Coffee w/sugar 90 calories
  • Coffee w/cream 90 calories
  • Coffee w/whole milk 60 calories
  • Coffee w/skim milk 30-50 calories

  Order a coffee with cream and sugar every work day?  Add 900 calories per week to your diet.  That is over 13 pounds in one year.

  Enjoy a cappuccino every day instead, and you save 300 calories per week, and cut 4 pounds per year from the above diet.

  Go to coffee with skim milk and Splenda?  Now you are only adding 250 calories per week, and under 4 pounds per year in coffee weight.

  Enjoy a flavored frappucino or latte once per week?  That could add up to 26,000 calories, and another 7.5 pounds per year.

  Just your coffee could account for 20 pounds of caloric intake annually!

  Steakhouse Choices
  • Caesars Salad- 800cals
  • Chopped Salad, 320cals
  • Spinach Salad, 170cals click here for more »

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• Recipe of the Month

  January 2012

  Drink alcohol a little more wisely!

  Drink Choices
  • Eggnog, 350cals
  • White Russian, 260cals
  • Riesling, 160-200cals
  • Shot of liquor, 70-125cals
  • Tonic or Soda, 100cals
  • Winter Beer, 150-200cals
  • Beer, 150cals
  • Bloody Mary, 130cals
  • Wine, 120cals
  • Light Beer, 55-85cals
  • Champagne, 85cals
  Enjoy a small glass of eggnog and two gin and tonics, and you have drank 750 worthless calories.
  Or, start with some champagne, and enjoy two glasses of wine and you only have drank 330 calories, less than half of your first choices.