The Mechanics of Plantar Fasciitis

Guest article writer today some reminders that are vaulable:

Plantar Fasciitis is a common athletic foot injury. While runners are most likely to suffer from Plantar Fasciitis, any athlete whose sport involves intensive use of the feet may be vulnerable. The risk of this injury increases in athletes who have a particularly high arch, or uneven leg length, though improper biomechanics of the athlete’s gait and simple overuse tend to be the primary culprits.

What is Plantar Fasciitis?

Plantar fasciitis refers to a type of foot injury which is an inflammation of the plantar fascia, a thick, fibrous band running along the sole of the foot. Such inflammation results from direct injury to the plantar fascia, usually, repeated trauma to the tissue where the fascia attaches to the calcaneus or heel bone. The plantar fascia is critical in maintaining the foot’s complex arch system, also playing a role in balance and fine control of certain phases of the athlete’s gait.

Injury to the plantar fascia is particularly painful and disabling for runners and can often prove stubbornly resistant to treatment. Rehabilitation is frequently a lengthy and frustrating process. For these reasons, care should be taken where possible to avoid such injury by means of preventative exercises and sensitivity to early warning signs.

Anatomy involved

A non-elastic band of fibrous tissue - he plantar fascia - runs along the bottom or plantar surface of the foot. It attaches to the calcaneus or heel bone, (the largest bone in the foot), fanning out and attaching to the metatarsal bones around the ball of the foot, at the base of the toes. Tension in the plantar fascia acts to maintain the arch of the foot.

Most commonly, the plantar fascia is injured at its attachment point on the medial tubercle of the calcaneus. During running, the arch of the foot flattens during the pronation phase, allowing the foot to absorb shock as it makes contact with the ground. Repetitive trauma to this tissue can produce micro tears, the signature of plantar fasciitis. Pain usually develops on the calcaneus of the foot.

What causes Plantar Fasciitis?

Plantar fasciitis foot injury generally occurs over time, rather than being the result of a single event. Micro trauma from repetitive stress to the tissue often combines with a biomechanical deficiency of the foot to produce the condition. In addition, arthritic and metabolic factors may contribute to the development of this injury, (though they are unlikely to affect young athletes). A variety of training errors commonly lead to plantar fasciitis, particularly a rapid increase in either volume or intensity of athletic activity. Volume refers to the distance or time an athlete performs, while intensity refers to the pace of activity and/or the recovery time allowed following performance.

Training on improper, hard and/or irregular surfaces as well as excessive track work in spiked shoes, or steep hill running, can stress the plantar fascia past its limits of elasticity, leading to foot injury. Finally, failure in the early season to warm up gradually gives the athlete insufficient time for the structures of the foot to re-acclimate and return to a proper fitness level for intensive exercise. Such unprepared and repeated trauma causes microscopic tearing, which may only be detected once full-blown plantar fasciitis and accompanying pain and debilitation have resulted.

If the level of damage to the plantar fascia is significant, an inflammatory reaction of the heel bone can produce spike-like projections of new bone, known as heel spurs. Indeed, plantar fasciitis has occasionally been refereed to as heel spur syndrome, though such spurs are not the cause of the initial pain but are instead a further symptom of the problem. While such spurs are sometimes painless, in other cases they cause pain or disability in the athlete, and surgical intervention to remove them may be required. A dull, intermittent pain in the heel is typical, sometimes progressing to a sharp, sustained discomfort. Commonly, pain is worse in the morning or after sitting, later decreasing as the patient begins walking, though standing or walking for long periods usually brings renewal of the pain.

Certain preconditions favor the development of the foot injury plantar fasciitis. These include genetic predisposition, excessive rigidity in the feet, overly high arches, (or by contrast, flat feet), and running on the toes or in very soft surfaces such as sand. Finally, improper footwear, particularly with insufficient arch support, is a recipe for injury.

Author: Brad Walker

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Article by Brad Walker. Brad is an internationally recognized stretching and sports injury consultant with 20 years of practical experience in the health and fitness industry. Brad is a Health Science graduate of the University of New England and has postgraduate accreditations in athletics, swimming and triathlon coaching. He has worked with elite level and world champion athletes and lectures for Sports Medicine Australia on injury prevention. Brad is also the author of The Stretching Handbook, The Anatomy of Stretching and The Anatomy of Sports Injuries.

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Basic Plantar Fasciitis Information

 Guest article writer today nothing new here just a reminder of some of the basics:

Plantar fasciitis is a painful foot condition which is common among middle aged women and men. This condition can be found in all age groups and can be identified as "heel spurs". Basically, this plantar fascitis is commonly referred to as a syndrome of inflamed tissue bands which runs from the heels and along the arch area of both feet. About 70% of patients diagnosed with plantar fasciitis have been noted to have a heel spur that can be seen on X-Ray. These heel spurs are a hook bone that can form on the calcaneus or heel bone in the foot.

The Diagnosis

The diagnosis of plantar fasciitis can be identified through the classic symptoms of well localized pain over the area of the heel over the bottom part of the foot. The pain which comes along with plantar fasciitis is often severe during the morning when you first stand and put on weight on your feet. Oftentimes, this pain will subside quickly and will resume after a prolonged period of walking and standing.

Causes of Plantar Fasciitis
Plantar fasciitis can be associated with a rapid weight gain which bears much weight to the feet after adding on a few pounds. On the other hand, this plantar fascitis is not always associated with weight gain. Athletes can have greater risk in having such condition due to the repetitive nature of the sports which can result into a wear-and-tear damage to the fibrous tissues which forms the arching area of the foot. With all these symptoms,plantar fasciitis is often confused with tarsal tunnel syndrome. An important nerve in foot area called tibial nerve is damaged. The trapping and pinching of the tibial nerve passes through the tarsal tunnel almost analogous to the wrist area affliction called the carpal tunnel syndrome and it causes similar pain which characterizes plantar fasciitis of the foot. Other causes can be stress fractures, nerve entrapments and fat pad necrosis can cause plantar fasciitis and can yield uncomfortable foot pain.

Plantar fasciitis happens when the ligamentous connective tissue is irritated. This tissue runs from the ball of the foot to the heel bone. This tight and strong tissue contributes in maintaining the arched are of the foot. There is tremendous stress being placed in this tissue. When there is an inflammation of the arched area of the foot tendonitis and tendinosis or degeneration of the tissue, it will cause painful attacks in this area of the foot even during normal activities of daily living.

The treatment for plantar fasciitis can be done to control the inflammation and eventually lessen the pain. Here are four helpful steps of which patients can consider to do in order to manage plantar fasciitis:

Rest to Avoid Further Damage
Clients who suffer plantar fasciitis must avoid the precipitating activities. You must take a few days off from the prolonged walking and standing as well as running activities. Resting the feet can help in eliminating the excruciating pain of that area and will give enough time for the inflammation to subside. The less stress you are putting on your feet, the better.

Cold Compress can do the Wonder

Cold compress with ice packs can help in diminishing the symptoms of inflammation which is predominantly the pain around the heel area. The ice packs will help in lessening the symptoms of the plantar fasciitis after an acute exacerbation of the uncomfortable symptoms.

Proper Exercise and Shoe Inserts

To lessen the tension around the tissues, it is best to do proper exercise and stretching moves around the area of the heel none. Simple morning and evening exercises can be done to make the pain subside. The use of shoe inserts is the key to the proper treatment of plantar fasciitis. This device can be used to control the pain and will allow the client to perform activities of daily living without discomforts. Night splints can be worn to keep the heel all stretched out during night time. The arch of the foot does not contract while you sleep and will eventually lessen the episodes of excruciating heel pain during the morning.

Pharmacological Treatments

Since the root cause of the plantar fasciitis is the inflammation of the ligamentous connective tissue in the foot, there is a need for anti-inflammatory medications to manage the pain and decrease the inflammation. During inflammation the body produces certain chemicals that would cause nocioceptors or the receptors for pain in the body to react, signaling the body that there is pain. Thus, during an inflammation period there is always pain which comes along with it. What these Anti-inflammatory medications are that they act on the nociceptors before chemicals such as prostaglandin and cystokinin reaches it and signals pain. Before using anti-inflammatory drugs, it is best to consult an orthopedic and get a prescription or whatever pharmacological regimen the doctor might recommend to manage the pain.

When plantar fasciitis occurs beyond 6 months, it is called as chronic plantar fasciitis. This can be treated by a method called ESWT or extracorporeal shock wave therapy. In this procedure, the energy pulses induces microtrauma to the tissues of the plantar fascia which is though to induce a repairing process of the body.

Author: Todd Schafer

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