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Plantar Fascitiis

What is plantar fasciitis?

Plantar fasciitis occurs when the thick band of tissue that stretches across the sole of your foot to connect your heel to your toes sustains repetitive, microscopic tears that lead to collagen degeneration and acute inflammation.

Initially, plantar fasciitis injuries cause mild to moderate heel pain that improves with movement. Many patients report having their worst symptoms during their first few steps of the day, or after an extended period of sitting.

Left untreated, plantar fasciitis can become a chronic condition that makes you less active and changes the way you walk, ultimately leading to other foot, knee, hip, or back problems.

What causes plantar fasciitis?

Your plantar fascia is designed to provide flexible, shock-absorbing support to the arch of your foot. When it routinely suffers too much stress or tension, it can develop tiny surface tears that irritate and weaken the fascia, causing significant heel pain.

People with tight calf muscles that limit ankle flexion are more prone to plantar fasciitis, as are those with either very flat feet or high arches. Likewise, people with inefficient walking patterns that place added stress on the plantar fascia are more likely to develop the injury.   

Many of Dr. Pathak’s patients work in occupations that require walking or standing on hard surfaces all day. She also treats long-distance runners, dancers, and other athletes who routinely put an inordinate amount of stress on their heels.

How is plantar fasciitis diagnosed?

Dr. Pathak can usually diagnose plantar fasciitis by performing a comprehensive foot exam that includes checking for areas of tenderness, testing your reflexes, balance, coordination, and muscle strength, and observing the way you stand and walk.

Because she’ll want to know about the nature of your foot pain, it’s a good idea to write down your symptoms for a few days before your appointment, noting when your pain is most severe and what makes it better or worse.

Approximately half of all plantar fasciitis patients also have heel spurs: A bony, hooked growth on the underside of the heel bone. Heel spurs don’t always contribute to heel pain, however.

Depending on your symptoms and medical history, Dr. Pathak may also use a diagnostic imaging test, such as an X-ray or MRI, to make sure your pain isn’t the result of something like a bone fracture or pinched nerve.

How is plantar fasciitis treated?

Plantar fasciitis is a highly treatable problem that usually responds well to conservative, nonsurgical measures, particularly when it’s diagnosed soon after the onset of symptoms.

Dr. Pathak often begins by prescribing rest, anti-inflammatory medication, and fascia-specific stretching techniques to help reduce swelling and promote healing. For patients whose jobs require them to stay on their feet, she can offer specific strategies to prevent the problem from getting worse.

Once the inflammation is under control, targeted physical therapy stretches can keep your plantar fascia and Achilles tendon flexible, while exercises that strengthen your lower leg muscles help stabilize your ankle and heel.

Other conservative treatment options include custom-fitted arch supports, a night splint for optimal stretching, and shoe recommendations based on your body type and activities.


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