The plantar fascia acts like a bowstring and supports the arch and several muscles inside the foot. When there is increased stress on the arch, microscopic tears can occur within the plantar fascia,
usually at its attachment on the heel. This results in inflammation and pain with standing and walking and sometimes at rest.
Under normal circumstances, your plantar fascia acts like a shock-absorbing bowstring, supporting the arch in your foot. If tension on that bowstring becomes too great, it can create small tears in
the fascia. Repetitive stretching and tearing can cause the fascia to become irritated or inflamed.
The major complaint of those with plantar fasciitis is pain and stiffness in the bottom of the heel. This develops gradually over time. It usually affects just one foot, but can affect both feet.
Some people describe the pain as dull, while others experience a sharp pain, and some feel a burning or ache on the bottom of the foot extending outward from the heel. The pain is usually worse in
the morning when you take your first steps out of bed, or if youâve been sitting or lying down for a while. Climbing stairs can be very difficult due to the heel stiffness. After prolonged
activity, the pain can flare-up due to increased inflammation. Pain is not usually felt during the activity, but rather just after stopping.
A physical exam performed in the office along with the diagnostic studies as an x-ray. An MRI may also be required to rule out a stress fracture, or a tear of the plantar fascia. These are conditions
that do not normally respond to common plantar fasciitis treatment.
Non Surgical Treatment
Stabilize the foot by using uniquely placed wedges, deep heel cups, and "posts" (stabilizers). When the foot is stabilized, it is brought back to a neutral or normal alignment. When the foot is in
its normal alignment, pronation and supination are reduced or completely corrected, and the abnormal pull on the Plantar Fascia is alleviated. This will allow the Plantar Fascia to begin to heal.
When healing occurs, the pain and inflammation gradually subside. Provide the specific amount of arch support that your foot requires. Our custom-made orthotics support not only the arch as a whole,
but each individual bone and joint that forms the arch. Whether your arch is flat or abnormally high, our custom-made orthotics will provide the support that you need. When the arch is properly
supported, the Plantar Fascia is protected and healing can begin. Aid in shock absorption. The primary shock absorbers of our feet, and therefore our body, are the Plantar Fascia and the arch. To aid
these structures, we construct our custom-made orthotics so that they provide semi-flexible support to the arch by "giving" to absorb the shock of each step, rather than our foot absorbing the shock
(our orthotics act in the same way a shock absorber does on an automobile). When your weight is removed from the orthotic, the arch returns to its original height since the material we use has a
built-in "memory." This action will help to keep the Plantar Fascia and arch healthy and pain free. Cushion the heel. Our custom-made orthotics use thin, cushiony, durable, materials to cushion and
protect the heel. This helps to alleviate painful heels.
Surgery is considered only after 12 months of aggressive nonsurgical treatment. Gastrocnemius recession. This is a surgical lengthening of the calf (gastrocnemius) muscles. Because tight calf muscles
place increased stress on the plantar fascia, this procedure is useful for patients who still have difficulty flexing their feet, despite a year of calf stretches. In gastrocnemius recession, one of
the two muscles that make up the calf is lengthened to increase the motion of the ankle. The procedure can be performed with a traditional, open incision or with a smaller incision and an endoscope,
an instrument that contains a small camera. Your doctor will discuss the procedure that best meets your needs. Complication rates for gastrocnemius recession are low, but can include nerve damage.
Plantar fascia release. If you have a normal range of ankle motion and continued heel pain, your doctor may recommend a partial release procedure. During surgery, the plantar fascia ligament is
partially cut to relieve tension in the tissue. If you have a large bone spur, it will be removed, as well. Although the surgery can be performed endoscopically, it is more difficult than with an
open incision. In addition, endoscopy has a higher risk of nerve damage.