“Yes, that’s right–eating that extra cookie may make your heel hurt!”
O.K., so maybe not one extra cookie, but several cookies over time that lead to excess weight gain may cause your plantar fascia (the shock absorber running along the bottom of your foot) to become irritated or inflamed! How, you ask? Let’s take some time to talk with Dr. Lasday about this this common, yet painful foot condition.
What exactly is plantar fasciitis?
Dr. Lasday: Plantar Fasciitis is an inflammation of the plantar fascia, a tight ligamentous band that runs along the bottom of the foot.
What are the symptoms of Plantar Fasciitis?
Dr. Lasday: Patients will often come in my office complaining of a sharp pain in the heel of their foot after the first few steps out of bed in the morning, or complain of pain in their heel after standing a long period of time. They sometimes describe it as a “stone” or “bruise” under the weight bearing surface of the heel. Usually it occurs in one foot at a time, but it can happen in both feet simultaneously.
What causes Plantar Fasciitis?
Dr. Lasday: Normally your plantar fascia acts like a shock-absorber, supporting the arch in your foot. But, too much tension on the plantar fascia can create small tears in the it. Its more like a rope than a rubber band, so small tears can form. Repetitive stretching and tearing can cause the fascia to become irritated or inflamed which leads to pain in the heel.
So, are there certain activities that cause greater tension on the plantar fascia?
Dr. Lasday: Absolutely, activities such as long-distance running, ballet dancing and dance aerobics — can lead to plantar fasciitis. Anything that places a lot of stress on your heel and attached tissue can put you at risk for this condition. People who stand for long period of time at their jobs, waitresses, teachers can end up damaging their plantar fascia over time.
Other there other factor that place a person at risk for developing this condition?
Dr. Lasday: Yes. Like we mentioned earlier, being overweight can stress your plantar fascia. Women, unfortunately, are more likely to develop plantar fasciitis than men. Also, age is a factor. People over 40 are more prone to this condition as well. Wearing poorly designed shoes are also a problem. And being flat-footed, or having a high arch can put added stress on the plantar fascia.
How do you diagnose this plantar fasciitis?
Dr. Lasday: I can generally figure it out by listening to what the patient is saying. We may use an x-ray or ultrasound in the office to visualize the fascia or the heel bone. Sometimes the x-ray will show a heel spur (a bony growth) on the heel, but this doesn’t necessarily mean the heel spur is causing the plantar fasciitis. Heel spurs are often mistakenly blamed for heel pain, when it is something entirely different causing the pain.
How do you treat plantar fasciitis?
Dr. Lasday: There are several ways we can approach this condition. Treating the root cause of the problem with stretching or a nighttime stretching splint is helpful. Over the counter insoles are helpful as well. Powerstep insoles are the best of the OTC insoles, but they are hard to find in stores. Just like eyeglasses, some people do just fine with an over the counter variety. Others need a prescription if the weakness is too much for the over the counter version to fix. Molds can be taken of the feet to get a custom orthotic. These usually solve the problem. Othertimes, anti-inflammatory medication, given either orally or in an injectable form, can be given. Rarely is surgery needed, but we do surgery in those cases where nothing else works.
What about the ultrasonic, or shockwave treatments that are advertised?
Dr. Lasday: I am not sold on that therapy at all. Not many people understand that still needs to be done in operating room and anesthesia is used. There is often pain afterwards, and crutches are usually needed. There is some literature studies that found that the shockwave can cause fractures in the heel bone, so I am not comfortable recommending this therapy, when other methods work so well.
If you or a loved one are exhibiting symptoms and suspect it may be plantar fasciitis, please schedule an appointment with Dr. Lasday right away for a thorough and professional evaluation, either in his Bradenton Podiatry office or Sarasota Podiatry office.