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Plantar Fasciitis

Heel pain occurs for various reasons.  Common causes of pain beneath the heel include gait and balance problems, flattening of the fat pad, inadequate or worn out shoes, overweight, spending long periods of time on your feet, week foot muscle with anatomical problems.  Symptoms of heel pain vary depending on the cause.  It may develop gradually or occur suddenly. Within the arches of our feet, there is a thick band of tissue called the plantar fascia.

This tissue is attached to the bottom of our heels, which bears much of our body weight. With time this tissue becomes chronically inflamed, leading to heel pain. One often under-recognized cause of plantar fasciitis is tight calves. As we move down the leg, our calf muscles become the Achilles tendon, which attaches to the heel bone, and continues into the foot as the plantar fascia. When our calves are chronically tight, it makes the Achilles tendon and plantar fascia more prone to injury or chronic inflammation. Some of the more common symptoms may include pain under the heel after prolonged walking or standing. The pain may be especially worse upon awakening in the morning or after prolonged sitting.

The treatment of plantar fasciitis rarely involves surgery. However it is important to know that heel pain rarely completely “goes away.” With the treatments I discussed, our goal is to help minimize the pain to a level that does not interfere with your daily activities or your quality of life.
The mainstay of treatment is stretching of the calf or Achilles. This helps to keep the plantar fascia “loose” and less prone to inflammation. Stretching should be done at least two to three times a day.
Wearing good supportive shoes or sneakers help especially by adding a cushioned heel pad to your shoe. This may come in the form of an orthotic device.  Another solution may be a night splint that keeps your ankle bent up towards your head thereby keeping your Achilles and plantar fascia in a stretched position overnight.
On some occasions after these modalities have failed, a formal physical therapy program may be initiated. Injections into the heel are also a common form of treatment. Repeated injections are not recommended in the heel as the cortisone can cause thinning of the fat pad of the heel and increase the risk of plantar fascia rupture, which can lead to other problems.

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