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Plantar Fasciitis

Plantar Fasciitis (pronounced "PLAN-tar fashee-EYE-tiss") is an inflammation of the plantar fascia, which encapsulates the muscles in the bottom of the foot and supports the arch of the foot.  "Plantar" refers the bottom of the foot, while "fascia" refers to the connective tissue system of the body, and "itis" refers to inflammation.  It is the most common pain treated by orthopedists.  Between 1% and 2.5% of the population suffers from this condition every year.  Athletes, runners, walkers and pregnant women are the groups most affected.

The plantar fascia is a broad ligament-like structure that acts as a bowstring connecting the ball of the foot to the heel.  It endures tension that is approximately two times body weight during walking at the time the heel of the trailing leg begins to lift off the ground.  The moment of maximum tension increases suddenly if there is a lack of flexibility in the calf muscles. Therefore, plantar fasciitis is usually a repetitive stress injury that is caused by walking.

Every percentage of increase in body weight will case the same percentage increase in the tension in the fascia.  This is why many pregnant women may develop this condition.

This condition may also be caused by a change or increase in daily activities, lack of flexibility in calf muscles, obesity, injury, lack of arch support in shoes, improperly cushioned shoes, inflexible shoes, or spending too much time either at a desk or standing.  Sometimes, no direct cause can be determined.  However, poor posture and imbalances in the body may also stress the fascial system and appear as pain in the plantar fascia.

Plantar fasciitis may be confused with, or considered the same as, a heel spur because the classic symptom is heel pain that occurs with the first few steps taken in the morning. Inflammation in the plantar fascia may impinge on nerves in the heel, which is what causes the pain to be felt in various areas.  The pain is usually in the front and bottom of the heel but may be over any portion of the bottom of the foot where the fascia is located.  In some patients, the pain will move to different locations on the bottom of the foot. The pain may also vary in strength from mild to debilitating.  This pain may occur intermittently, last for several weeks, or become permanent.  There is no standard location or normal length of time for this pain.

The standard medical treatment for this condition is rest, ice, periodic stretching, non-steroidal anti-inflammatory drugs (NSAIDS), splints, and injections.  Cortisone injections into the heel must be used sparingly, since they can contribute to the breakdown of the fat pad located on the heel, which may create more painful conditions.  None of the standard treatments provide immediate relief, and must be used for a period of time before a determination is made as to the effectiveness.  In cases that do not respond to standard treatment or progress, surgery may be recommended.  Lifestyle changes are also recommended, and activities are limited in order to prevent continued stress on the feet.  Different combinations of treatments may work for different people, but none address the main problem in this condition, which is the bound fascia.

The specific manual techniques used at Windsong Therapy and Wellness work to release the fascia and balance the body. This relieves the pain and allows the patient to resume an active functional lifestyle.  Many patients begin feeling a decrease in pain and increased range of motion after the first treatment.

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This website last updated on 31 July 2010

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