Foot pain affects nearly all people at one time or another. It can also lead to other musculoskeletal problems such as ankle, knee and back pain (Hill et al., 2008). This pain negatively affects
oneâs quality of life and ability to enjoy workouts and/or maintain a regular program of exercise. One of the most common sources of foot pain is plantar fasciitis, a condition where the connective
tissue on the underside of the foot becomes irritated and painful as a result of an injury, overuse or misuse. The plantar fascia is a system of connective tissue that runs from your heel to just
behind your toes. During weightbearing activities, such as walking or running, your body weight is transferred onto your foot from your heel to your toes (which results in your toes moving away from
your heel). This spreading out of the foot places tension on the plantar fascia because it connects those two parts. If the tension on this structure is too great or is not dispersed evenly, the
plantar fascia can develop microtears and become irritated and painful, resulting in a condition called plantar fasciitis.
Plantar fasciitis occurs when the ligament in your foot arch is strained repeatedly, which causes tiny tears and significant pain. There are several possible causes for this condition. Excessive
pronation, or overpronation, which happens when your feet roll excessively inward as you walk. Flat feet or high arches. Walking, standing, or running for long periods of time, particularly on hard
surfaces (a common problem for athletes). Excess weight, such as overweight or obesity. Shoes that are worn out or donât fit well. Tight calf muscles or Achilles tendons.
Heel pain is the most common symptom associated with plantar fasciosis. Your heel pain may be worse in the morning or after you have been sitting or standing for long periods. Pain is most common
under your heel bone, but you also may experience pain in your foot arch or on the outside aspect of your foot. Other common signs and symptoms of plantar fasciosis include mild swelling and redness
in your affected area, tenderness on the bottom of your heel, impaired ability to ambulate.
To arrive at a diagnosis, the foot and ankle surgeon will obtain your medical history and examine your foot. Throughout this process the surgeon rules out all the possible causes for your heel pain
other than plantar fasciitis. In addition, diagnostic imaging studies such as x-rays or other imaging modalities may be used to distinguish the different types of heel pain. Sometimes heel spurs are
found in patients with plantar fasciitis, but these are rarely a source of pain. When they are present, the condition may be diagnosed as plantar fasciitis/heel spur syndrome.
Non Surgical Treatment
Many cases of plantar fasciitis can be treated with simple, conservative measures. These include ice packs, stretching exercises, anti-inflammatory medications, orthotic devices (custom molded
orthotics), and physical therapy. Itâs important to consult your doctor before you take any medications to treat this condition. In chronic or persistent cases, one of three techniques may be used
to treat plantar fasciitis. Extracorporeal Shock Wave Treatment (ESWT). TOPAZ treatment. Platelet Rich P
Surgery is usually not needed for plantar fasciitis. About 95 out of 100 people who have plantar fasciitis are able to relieve heel pain without surgery. Your doctor may consider surgery if
non-surgical treatment has not helped and heel pain is restricting your daily activities. Some doctors feel that you should try non-surgical treatment for at least 6 months before you consider
surgery. The main types of surgery for plantar fasciitis are Plantar fascia release. This procedure involves cutting part of the plantar fascia ligament . This releases the tension on the ligament
and relieves inflammation . Other procedures, such as removing a heel spur or stretching or loosening specific foot nerves. These surgeries are usually done in combination with plantar fascia release
when there is lasting heel pain and another heel problem. Experts in the past thought that heel spurs caused plantar fasciitis. Now experts generally believe that heel spurs are the result, not the
cause, of plantar fasciitis. Many people with large heel spurs never have heel pain or plantar fasciitis. So surgery to remove heel spurs is rarely done.
Do your best to maintain healthy weight. Plantar fasciitis is caused by wear and tear on your feet. Being overweight drastically increases the pounding your feet take every day. Even losing a few
pounds can help reduce heel pain. Avoid jobs that require walking or standing for long periods of time. Having your body weight on your feet all day puts a lot of pressure on your plantar fascia
tissue. Replace your shoes on a regular basis. Buy new shoes when the old ones are worn-out. Make sure your shoes will fit your foot size comfortably at the end of the day. Pay attention to the width
as well as the length. Use good supportive shoes that will help you with your original problem like arch support, motion control, stability, cushioning etc. Stretch regularly as part of your daily
routine. There are a few special stretching techniques for the prevention. Choose soft surfaces for your exercise routine to walk, jog or run on. Rest and elevate your feet every chance you have.
Strengthen your foot muscles as part of your exercise routine. Strong foot muscles provide a good support to the plantar fascia. Change your shoes during the work week. Don't wear the same pair of
shoes every day. Perform Warm up exercises such as a short period of walking, a light jog or other easy movement and then stretch before starting the main exercise. Try to avoid dramatic changes in
your exercise routine. Increase your exercise level gradually. Donât run long distance if you are used to walk. Make the change slowly and gradually. Pay attention to your foot pain, do not ignore
it. Visit your doctor if the pain continues. Avoid the activities that cause you pain. Use over-the-counter Orthotics or inserts that your doctor may prescribe. Off-the-shelf or custom-fitted arch
supports (orthotics) will help distribute pressure to your feet more evenly. Try to avoid barefoot walking, since it may add stress on the plantar fascia ligament.