Have you ever gotten out of bed first thing in the morning only to feel a sharp pain in your foot when taking your first steps? Sometimes that pain lingers for a while but then goes away after you’ve walked for a bit. If you’ve experienced this scenario, you may have been dealing with Plantar Fasciitis. Plantar fasciitis is when the thick band of tissue that runs across the bottom of your foot (plantar fascia), connecting your heel bone to your toes, is inflamed. The pain from plantar fasciitis usually occurs early in the morning with your first steps and trails off as the day progresses, but it can show up when you’ve been standing or sitting for a long period.
Generally, plantar fasciitis will cause stabbing pain in the bottom of the foot near the heel but can spread through the arch of the foot and toward the toes. Plantar fasciitis is the result of tension and stress on your plantar fascia causing small tears within the tissue. It’s important to note that in many cases of plantar fasciitis, the cause is unknown. Those who are between the ages of 40-60 are at higher risk of experiencing plantar fasciitis, along with those who participate in exercises such as long-distance running, ballistic jumping activities, ballet dancing, and aerobic dance. You may also be at a higher risk if you are flat-footed, have a high arch, walk with an abnormal gait, if you’re overweight, and if you are on your feet for extended periods of time.
Plantar Fasciitis is generally treated with rest, ice, massage, and stretching the toes up, and exercises to strengthen the bottom of the foot. You may want to talk to your doctor about over-the-counter anti-inflammatories and pain medications that may help as you begin treatment. You may also be able to pair yourself with a physical therapist that can put together exercises for you to perform to stretch the plantar fascia and Achilles tendon and to strengthen your foot and lower leg muscles. It may be recommended that you wear a night splint created to stretch your calf and the arch of your foot while you sleep, or custom-made arch supports or orthotics, which will help dissipate the pressure placed on your feet with each step. If you have poor results from said treatments, you may need to increase your treatment program. More serious treatments include steroid injections into the area to decrease inflammation, extracorporeal shock wave therapy which is where soundwaves are directed at the area of heel pain to help with healing, and finally, surgery, which is rarely needed and used when the pain is severe and all other treatments have failed. While these treatments have been proven to work, they have their downfalls as well. Multiple steroid injections can weaken the plantar fascia resulting in its rupturing, extracorporeal shockwave therapy may cause bruising, swelling, pain, numbness, and tingling, and surgery can result in the weakening of the arch in your foot.
While many have heard of the term plantar fasciitis, few have heard the term plantar fasciitis. Plantar fasciitis is kind of an umbrella term used for any kind of issue derived from the plantar fascia. However, it’s often used to describe the degeneration of the abductor hallucis (the muscle that moves your big toe out toward the midline) due to circulation issues. As opposed to inflammation of the area, plantar fasciosis results in the death of the plantar fascia because the tissue isn’t receiving enough blood, and therefore not enough oxygen and nutrients. Since the abductor hallucis is meant to keep the big toe straight and move it toward the midline, if you’re constantly wearing shoes with a narrow toe box, pushing the toes together, or tend to walk on the inside of your foot, this may very well be the cause. Essentially what’s happening is the abductor hallucis is stretched beyond its normal capacity over time and that tightness of the muscle puts pressure on the underlying blood vessel that supplies the plantar fascia, effectively cutting off the blood supply and causing deterioration and tissue death of part of the plantar fascia.
The really interesting thing about this is that the exercise and treatment protocols that help plantar fasciitis may not help plantar fasciosis at all, and in some cases may even make it worse. Plantar fasciitis is often helped with rest, ice, and stretching the toes up and out to the side. But if plantar fasciosis is the real problem, these are the opposite of what will help. Instead, for plantar fasciosis, flexion of the toes, abduction of the big toe, and heat are more likely to address the real issue.
When experiencing any pain within the foot and heel area, it is imperative that you see your doctor as soon as possible so they can properly diagnose and get you on the right treatment plan before more damage can be done. It is also important to make sure that you are wearing shoes that support the natural alignment of your foot.