Plantar fasciitis affects many people from the avid runner to the worker that stands most of the day. In fact, it is one the most common causes of heel pain. Plantar fasciitis occurs due to a thickening of the soft tissue of the bottom of the foot. The fascia, after being stressed for many days or weeks, starts to break down and inflammation sets in. This process may involve no pain what so ever.
The fascia will start to thicken and possibly long with the little toe muscles, pull on the heel bone creating a heel spur. A sharp pain in the morning and after long periods of being ideal starts to occur. The pain is usually described as intense, sharp pain for the first couple of steps that gradually gets better with walking. If nothing is done than the pain can begin to occur more often and not dissipate as steps are taken.
This thickening can occur due to having an over-pronated foot or flatten arch as well as having an overly supinated foot or high arch. The symptoms are almost identical for the high and low arched foot but the treatment needs to be individualized and different for each person and their foot. the low arched individual generally has an over-stretched plantar fascia and loose joints in their feet. The high arched person generally have a tight, shortened fascia and a rigid, tight foot. The two different presentations need and should be treated very differently.
Medically, plantar fasciitis, caused by low or high arches, are most commonly treated with rest, NSAIDs/cortisone injections and orthotics. Surgery to remove stress on the fascia or to remove the spur associated with plantar fasciitis can also be performed. Conservatively, intrinsic foot muscle strengthening, joint mobilization, and myofascial release can successfully decrease symptoms and relieve plantar fasciitis.
Yours in health,
Dr. Justin Hildebrand