Foot Pain Services
Heel Spurs and Plantar Fasciitis
Plantar fasciitis is a very common cause of heel pain and most common between ages 40 to 60. It involves inflammation of the plantar fascia, a thick band of tissue that runs across the bottom of your foot and connects your heel bone to your toes.
Normally, your plantar fascia supports the arch of your foot and helps with shock absorption. If tension and stress placed on it becomes too great, microscopic tears can occur in the fascia. Repetitive stretching and tearing can cause the fascia to become inflamed and painful.
Plantar fasciitis very commonly causes a pain that is stabbing in nature, and usually comes on with your first steps in the morning. As you get up and walk about more, the pain usually decreases, but it might return after long periods of standing or after getting up from sitting. The pain is usually worse after exercise, not during it.
Plantar fasciitis is very common in runners. Additionally, people who are overweight and those who wear shoes with improper insoles that don’t provide adequate support are at an increased risk of plantar fasciitis.
Steroid injections and surgery should not be first choices in treating this condition. Physical therapy and proper footwear are very effective in treating most cases.
Main risk factors for plantar fasciits are:
- Certain types of activities: Physical activity that places a lot of stress on your heel and attached tissue such as long-distance running, ballistic jumping activities and ballet dancing can contribute to an earlier onset of plantar fasciitis.
- Poor foot mechanics: Being flat-footed, having a high arch or even having an abnormal walking pattern can affect the way your weight is distributed when you're standing and put added stress on the plantar fascia. Poor neck posture and lack of thoracic mobility are also contributing factors.
- Obesity: Excess pounds put additional mechanical stress on your plantar fascia. There is also a theory that fat deposition within the fascia contributes to pain.
- Occupations where you are on your feet a lot: Factory workers, teachers and others who spend most of their work hours walking or standing on hard surfaces can injure their plantar fascia.
Ignoring plantar fasciitis may result in chronic heel pain that hinders your regular activities and also affect the manner in which you walk. This may cause you to develop foot, knee, hip or back problems as you try to compensate. When plantar fasciitis is chronic, calcium is deposited into the inflamed tissue and causes heel spurs that are visible on X-ray. However, in most cases the heel spur is not the direct cause of heel pain.
While steroid injections are a common quick fix, the relief may be temporary and it does nothing to solve the root problem. We usually advise physiotherapy in most cases of plantar fasciitis. However, if you choose to receive a steroid injection into the heel for quick relief, be sure to engage in physical therapy after, because the pain can be worse if the plantar fasciitis returns. Also, discuss with you doctor the possible side effects of continuous steroid medication before choosing to receive it.
Achilles tendinitis is an overuse injury of the achilles tendon. The achilles tendon (calcaneal tendon) is the tendon that connects calf muscles at the back of the lower leg to your heel bone. This is the tendon that is involved when you walk, run, jump or push up on your toes.
Runners who have suddenly increased the intensity or duration of their runs are at a high risk of developing this condition. It's also common in middle-aged people who play sports, such as tennis or basketball, but only on the weekends.
In most cases, achilles tendinitis can be treated with a basic home regimen under your doctor's supervision. Self-care strategies are usually necessary to prevent recurring episodes. More-serious cases of achilles tendinitis can lead to tendon tears (ruptures) that may require surgical repair. In the case of a complete rupture, you won’t be able to extend the foot, that is point the toes towards the floor.
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