Plantar fasciitis is one of the most common and most easily identifiable causes of chronic foot pain and affects both young active patients and older sedentary individual. Plantar fasciitis is an inflammation of the plantar fascia, a piece of strong, thick tissue that runs along the bottom of the foot. It connects the heel bone to the toes, creating the arch of the foot. Inflammation is onset by the process of stretching plantar fascia beyond the normal range of extension, which causes fibrous tissue to tear, or over-stretch. This may be painful and may feel worse when walking (especially on the first steps of the day) and improved when resting.
Treatment
These nonoperative treatments lead to complete resolution of pain in 90% of patients but can take 3-6 months. For long term sufferer’s corticosteroid injections temporarily relieve pain but may increase the risk of plantar fascia rupture. Botulinum toxin injections relax the calf muscles, which decreases the stress in the plantar fascia. Operative treatments include gastrocnemius recession and medial head of gastrocnemius release, which decrease the stress on the plantar fascia.
Peter Webster
Workers Compensation Specialist (AEP, ESSAM)
Exercise Rehabilitation Services ‑ WA
References
J. Miller and Z. Russell, ‘Plantar Fasciitis’ (Physio Works) <https://physioworks.com.au/injuries-conditions-1/plantar-fasciitis> accessed 6 June 2019.
Thompson JV et al., Diagnosis and management of plantar fasciitis. J Am Osteopath Assoc. 2014 Dec;114(12):900-6. <https://www.ncbi.nlm.nih.gov/pubmed/25429080> accessed 7 June 2019
Gill and Kiebzak et al., Outcome of nonsurgical treatment for plantar fasciitis. Foot Ankle Int. 1996 Sep;17(9):527-32. <https://www.ncbi.nlm.nih.gov/pubmed/8886778> accessed 7 June 2019.