Plantar Fasciitis

Daily Health Solutions
on April 8, 2011

The problem: Plantar Fasciitis

What it is: Inflammation of the plantar fascia, the flexible band of tissue that runs from your heel to the ball of your foot, forming your arch. “The plantar fascia is the foot’s shock absorber,” explains Dr. Matzkin, an assistant professor in the department of orthopaedics at Tufts University in Boston.

Probable cause: Too much activity before you’re fit enough to handle it, or wearing shoes without arch support, especially if you have flat feet. Another cause: a super-tight Achilles tendon, which connects your heel to your calf muscles.

Telltale symptoms: Sharp heel pain when you take your first steps in the morning. “As you move, your foot warms up and the pain goes away,” says Dr. Bob Baravarian, chief of Podiatric Foot & Ankle Surgery at Santa Monica/UCLA Medical Center and Orthopedic Hospital. Don’t ignore the symptoms, however. If you do, the problem will worsen.

Prevention 101: Stretch your Achilles tendons and calf muscles, advises Dr. Baravarian, director of the University Foot & Ankle Institute in Los Angeles. (For stretches, see “Stretch It Out.”) Ease into physical activity, increasing the duration and intensity of your workouts by no more than 10 percent per week. And wear shoes with arch support. “At the end of the summer, I see an increase in heel pain in people who wear flip flops or Crocs, which don’t have a lot of support,” says Dr. Matzkin. Ditto for ballet flats. Our sandal-of-choice for summer: The Spirit from Dr. Andrew Weil Integrative Footwear. It has plenty of arch and heel support, plus tons of style.

Treatment: In addition to stretching, wearing shoes with a one to one-and-a-half inch heel (with your doctor’s OK) can help ease the pain. “A higher heel decreases tightness and lets both the plantar fascia and Achilles tendon rest,” says Dr. Baravarian. So will inserting an insole with arch support in flat shoes. Another strategy: Freeze a small plastic water bottle. Then roll it back and forth with your foot, moving from the bottom of your heel to the ball of your foot and back. “Ice will decrease inflammation,” says Dr. Baravarian.  If conservative measures don’t help, your doctor may recommend that you wear a night splint to hold your foot in a flexed position, stretching the plantar fascia as you sleep, explains Dr. Matzkin. You also may be candidate for prescription orthotics to lessen strain on the fascia. Persistent plantar fasciitis causes scar tissue to develop. If that happens, treatments such as cortisone injections, shockwave  therapy or surgery help break up the scar tissue.