Plantar Fasciitis

Common Causes & Risk Factors

The plantar fascia acts as a shock absorber, supporting the arch of your foot. When tension and stress on this ligament become too great, small tears can occur, leading to inflammation and pain. While the exact cause is not always clear, several factors can increase your risk of developing plantar fasciitis.

These risk factors include:

• Age: This condition is most common between the ages of 40 and 60.
• Repetitive physical activity: Activities that place a lot of stress on your heel, such as long-distance running, ballet dancing, and aerobic dance, can contribute to its onset.
• Foot mechanics: Having flat feet, a high arch, or an abnormal walking pattern can affect the way weight is distributed, adding stress to the plantar fascia.
• Obesity: Excess weight can put extra pressure on your plantar fascia.
• Standing for long periods: Factory workers, teachers, and others who spend most of their work hours walking or standing on hard surfaces are at a higher risk.

Symptoms of Plantar Fasciitis

The most common symptom of plantar fasciitis is pain in the bottom of the foot, near the heel. This pain can manifest in several ways:

• Stabbing pain in the bottom of the foot, often most severe after long periods of rest.
• Pain triggered by long periods of standing.
• A dull, aching pain that worsens throughout the day.
• Post-activity pain that flares up immediately after participating in physical activity.

If you find you experience the above symptoms and that they are impacting your ability to live comfortably, we encourage you to seek professional evaluation at your earliest convenience. Timely diagnosis is essential for treatment.

Diagnosing Plantar Fasciitis

A proper diagnosis is the first step toward effective treatment. At The Centers for Advanced Orthopaedics Orthopaedic Associates of Central Maryland Division, our specialists begin with a thorough physical examination. We will check for points of tenderness in your foot and assess your medical history to understand the nature of your pain.

Your doctor will evaluate the strength of your muscles and the health of your nerves by checking your reflexes, muscle tone, and coordination. While imaging tests like X-rays or MRIs are not usually necessary, they may be used to rule out other problems, such as a stress fracture or a pinched nerve. This careful evaluation ensures we create a treatment plan that is right for you.

Treatment Options for Plantar Fasciitis

We believe in a patient-centered approach, offering a range of treatments from conservative methods to advanced procedures. Our goal is to reduce inflammation, relieve pain, and help you return to your normal activities. Your treatment plan will be tailored to your specific needs and the severity of your condition.

Nonsurgical Treatments

The majority of patients with plantar fasciitis improve with conservative, nonsurgical treatments. These methods are focused on relieving stress on the plantar fascia and reducing inflammation. Our team will guide you through these initial steps to promote healing.

Initial treatments often include:

• Rest: Limiting activities that aggravate the pain is crucial.
• Ice: Applying ice to the affected area for 15-20 minutes several times a day can help reduce inflammation.
• Stretching: Gentle stretches for the Achilles tendon and plantar fascia can relieve tension.
• Supportive Footwear: Wearing shoes with good arch support and cushioning can make a significant difference.
• Orthotics: Over the counter or custom-fitted arch supports (orthotics) help distribute pressure more evenly.
• Night Splints: A splint that stretches your calf and the arch of your foot while you sleep can help relieve morning pain.

Advanced & Minimally Invasive Treatments

If conservative treatments do not provide sufficient relief after several months, we may recommend more advanced options. These minimally invasive procedures are designed to promote healing without the need for traditional surgery. We will discuss these options with you to determine the best path forward.

Advanced treatments can include:

• Corticosteroid Injections: Injecting a type of steroid into the tender area can provide temporary pain relief, but multiple injections are not recommended.
• Platelet-Rich Plasma (PRP) Injections: This procedure uses your own platelets to stimulate the body's natural healing process in the damaged tissue.
• Extracorporeal Shockwave Therapy (ESWT): Sound waves are directed at the area of heel pain to stimulate healing.

Surgical Options

Surgery is typically reserved for cases where pain is severe and has not responded to other treatments for at least six to twelve months. The decision to proceed with surgery is made by both you and your specialist.

The most common surgical procedure is a plantar fascia release, which involves partially cutting the plantar fascial ligament to relieve tension. This can be performed as an open surgery or through a smaller incision. Your surgeon at The Centers for Advanced Orthopaedics Orthopaedic Associates of Central Maryland Division will explain the risks and benefits to help you make an informed decision.

Rehabilitation & Recovery

Recovery depends on the treatment you receive and your commitment to the rehabilitation plan. For nonsurgical treatments, consistent stretching and lifestyle adjustments are key to a successful outcome. Physical therapy often plays a vital role, teaching you exercises to strengthen your lower leg muscles and stabilize your walk.

If you undergo surgery, the recovery period will be more extensive. You may need to use crutches or wear a boot for a period to keep weight off your foot. A structured rehabilitation program will be essential to regain your strength and flexibility.

Preventing Plantar Fasciitis & Self-Care Tips

Taking proactive steps can help prevent plantar fasciitis from developing or recurring. Common preventive measures include:

• Maintaining a healthy weight.
• Choosing supportive shoes and replacing them regularly.
• Incorporating gentle stretching into your daily routine, especially before and after exercise.
• Adding low-impact physical activities, like swimming and cycling, into your high-impact exercise routine.

Listening to your body and resting when you feel pain is crucial for long-term foot health.

When to See a Specialist for Plantar Fasciitis Pain

You should consider seeing a specialist if your heel pain does not improve after several weeks of self-care. If the pain is severe, interferes with your daily activities, or continues to worsen, a professional evaluation is necessary.

The specialists at The Centers for Advanced Orthopaedics Orthopaedic Associates of Central Maryland Division are here to provide an accurate diagnosis and effective treatment.

Frequently Asked Questions