The plantar fascia is made up of 3 distinct parts: the medial, central, and lateral bands. The central plantar fascia is the thickest and strongest section, and this segment is also the most likely
to be involved with plantar fasciitis. In normal circumstances, the plantar fascia acts like a windlass mechanism to provide tension and support through the arch. It functions as a tension bridge in
the foot, providing both static support and dynamic shock absorption.
Plantar fasciitis is caused by small, repetitive trauma to the plantar fascia. This trauma can be due to activity that puts extra stress on the foot. Plantar fasciitis is most common in people who
are 40-60 years old. Other risk factors that increase your chance of getting plantar fasciitis include physical exertion, especially in sports such as running, Volleyball, tennis, a sudden increase
in exercise intensity or duration, physical activity that stresses the plantar fascia. People who spend a lot of time standing, a sudden increase in activities that affect the feet, obesity or weight
gain, pre-existing foot problems, including an abnormally tight Achilles tendon, flat feet, or an ankle that rolls inward too much. Poor footwear. Heel spurs.
When a patient has plantar fasciitis, the connective tissue that forms the arch of the foot becomes inflamed (tendonitis) and degenerative (tendinosis)--these abnormalities cause plantar fasciitis
and can make normal activities quite painful. Symptoms of plantar fasciitis are typically worsened early in the morning after sleep. At that time, the arch tissue is tight and simple movements
stretch the contracted tissue. As you begin to loosen the foot, the pain usually subsides, but often returns with prolonged standing or walking.
A health care professional will ask you whether you have the classic symptoms of first-step pain and about your activities, including whether you recently have intensified your training or changed
your exercise pattern. Your doctor often can diagnose plantar fasciitis based on your history and symptoms, together with a physical examination. If the diagnosis is in doubt, your doctor may order a
foot X-ray, bone scan or nerve conduction studies to rule out another condition, such as a stress fracture or nerve problem.
Non Surgical Treatment
There are many different ways to treat plantar fasciitis but there is no one treatment that works for everyone. Different treatment techniques affect patients in different manner. Every patient has
to be dynamic in their treatment activity. Trying a few different treatment techniques is usually necessary before finding the suitable ones. As progress is made and the pain decreases a new
treatment approach should be considered.
Surgery is usually not needed for plantar fasciitis. About 95 out of 100 people who have plantar fasciitis are able to relieve heel pain without surgery. Your doctor may consider surgery if
non-surgical treatment has not helped and heel pain is restricting your daily activities. Some doctors feel that you should try non-surgical treatment for at least 6 months before you consider
surgery. The main types of surgery for plantar fasciitis are Plantar fascia release. This procedure involves cutting part of the plantar fascia ligament . This releases the tension on the ligament
and relieves inflammation . Other procedures, such as removing a heel spur or stretching or loosening specific foot nerves. These surgeries are usually done in combination with plantar fascia release
when there is lasting heel pain and another heel problem. Experts in the past thought that heel spurs caused plantar fasciitis. Now experts generally believe that heel spurs are the result, not the
cause, of plantar fasciitis. Many people with large heel spurs never have heel pain or plantar fasciitis. So surgery to remove heel spurs is rarely done.
Stretching exercises for the Achilles tendon and plantar fascia are recommend to relieve pain and aid in the healing process. Sometimes application of athletic tape is recommended. In moderate or
severe cases of plantar fasciitis, your doctor may recommend you wearing a night splint, which will stretch the arch of your foot and calf while you sleep. This helps to lengthen the Achilles tendon
and plantar fascia for symptom relief. Depending on the severity of your plantar fasciitis, your physician may prescribe a store-bought orthotic (arch support) or custom-fitted orthotic to help
distribute your foot pressure more evenly.