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Discussion on plantar fasciitis
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Look here for a discussion on plantar fasciitis.
Plantar fasciitis is characterized by pain either in the ball of the foot or back by the heel. The pain is often very severe in the morning decreasing after walking, stretching or massaging the foot for a few minutes. Sometimes the pain only comes on after you have been walking or running for several minutes.
What causes the pain? The plantar fascia is a piece of connective tissue that connects the ball of the foot to the heel. The pain of plantar fasciitis comes from damage to that connective tissue. The pain is often severe in the morning because while we sleep our feet drop, shortening the distance between the ball of the foot and the heel. The plantar fascia trys to use this time to heal and shortens in order to protect itself while that happens. With your foot dropped while you sleep, the plantar fascia can shorten significantly. When we then stand in the morning we drastically stretch that fascia out and experience the characteristic pain. For people who don't experience the pain until they have been active for a while, the pain is caused by the plantar fascia being repeatedly stretched while using the foot.
What to do? When you get right down to it, plantar fasciitis is really just a bad case of tendonitis. There are three cardinal rules in dealing with any tendonitis; rest, ice and anti-inflammatory medication. Rest is often difficult because most of us don't have the luxury of getting off our feet for a couple weeks, we just have to walk. A heel lift is an excellent way to rest the plantar fascia while still remaining functional. Lifting the heel reduces the amount stress transferred to the plantar fascia. The heel lift we recommend is the ViscoSpot by Bauerfeind. The ViscoSpot was designed for plantar fasciitis sufferers and has the added benefit of being very soft and comfortable to wear. If cost is the primary issue, we have solid rubber lifts for significantly less money. Arch supports are often prescribed instead of heel lifts. Either method has been found to be equally effective. A good rule of thumb is to note where the pain is. If the pain is close to the ball of the foot, arch supports may provide more pain relief. The arch supports we recommond are the Spenco Orthotics. They are an inexpensive, but effective, over the counter orthotic. If the pain is closer to the heel, go with the heel lifts. If you have tried one with no success, simply try the other. That is the approach many excellent physicans take.
To prevent the shortening of the plantar fascia while you sleep, we recommend using a night splint. This is a device that is worn while you sleep that keeps the foot from dropping. The plantar fascia is kept from shortening, allowing it to heal in a functional position and preventing the drastic morning pain. The night splint has been found to be one of the most effective tools in treating plantar fasciitis and we highly recommend using it until the condition is completely healed. The night splint appears somewhat bulky, but is easily adapted to. People generally have little trouble sleeping in it and definitely prefer the splint to the morning pain.
Ice can be applied with ice in a plastic bag or with a gel ice pack. If you are going to use ice in a plastic bag, it will be much more effective if you crush the ice first. This will make the application much more comfortable and effective. If you donít want to deal with the hasle of ice, a gel ice pack is equally effective and much more convenient. Ice should be applied for 20 to 30 minutes as often as every two hours. (If using a gel ice pack, remember to never put the plastic pack directly against the skin. A pillow case is an excellent cover that will allow for the cold to penetrate but protect your skin from frost bite. See our discussion of heat v.s. cold in the Hot and Cold Therapy section.)
Often with plantar fasciitis, anti-inflammatory medication is needed to knock out any existing inflammation, especially if you have been suffering from the condition for an extended period of time. You should discuss taking this or any other medication with your physician.