You never realize how much you rely on a certain body part until it has been injured. This holds especially true for foot injuries. There is no easy way to allow the feet to rest when they hurt and the pain is felt with each and every step. Two of the most common causes of pain in the bottom of the heel, the arch, or both the heel and the arch, are plantar fasciitis and heel spurs.
Plantar fasciitis is an inflammation of the soft tissue on the bottom of the foot, termed plantar fascia. The plantar fascia is a thick ligamentous/fibrous band that attaches from the heel to the ball of the foot. Plantar fasciitis usually occurs at its attachment to the heel; however, the inflammation and pain of plantar fasciitis can occur anywhere along the bottom of the foot.
People with fallen arches or flat feet tend to have trouble with plantar fasciitis because the soft tissue is chronically stretched. Walking on flattened arches abnormally pulls the relatively inflexible plantar fascia, which in turn puts increased stress on the heel.
Similarly, people with high arches may also develop plantar fasciitis as the soft tissue becomes adaptively shortened and stretched. Similar to low arches, when walking weight is transferred from the heel to the remainder of the foot and the tight plantar fascia hardly stretches at all, pulling with great force on its attachment to the heel.
In both cases, the abnormal stress placed on the attachment of the plantar fascia to the heel usually causes pain and inflammation. If this process continues, the plantar fascia partially tears away from the heel and the body fills in this torn area with calcium; eventually it becomes bone, and a heel spur may result.
A heel spur is a piece of calcium or bone that sticks out from the bottom of the heel bone, and lies within the fibers of the plantar fascia. When walking, the spur digs into the plantar fascia and causes small micro-tears in the plantar fascia. This produces inflammation and pain in the heel, which also may radiate to the arch.
The most common sign of these problems is pain in the bottom of the heel or arch when first standing up out of bed in the morning, which gradually improves with walking. This pain may return later in the day with continued walking. The pain usually subsides after a period of rest, but will not go away completely until the abnormal pulling is controlled.
The best treatment to correct the abnormal pulling of the plantar fascia involves correcting the underlying mechanical problems. This is usually accomplished first with custom foot orthotics that not only support the arches, but also correct the mechanical misalignment of the foot/ankle. Then, physical therapy aids in restoring the length, strength and support of the plantar fascia, thereby reducing/abolishing the inflammation. These treatments, along with lifestyle modifications including avoiding excessive time on your feet, wearing appropriate footwear and minimizing walking barefoot, usually yield very good results. There are always more invasive treatments to consider (night splints, injections, surgery, etc.) if the conservative treatments are ineffective.
If you are unsure of the nature of your foot problem, consult a professional as soon as possible; as with all medical problems, the sooner you get treatment the better.
At Conshohocken Physical Therapy, our mission is to make a positive impact, both personally and therapeutically, on every person who enters our office. We believe we can change your life.
You will experience pain relief, improved motion and a greater quality of life. You will be treated by a Doctor of Physical Therapy who has the most specialized training to help you get back in motion. You will get direct attention from your Physical Therapist for at least 30 minutes during every visit.
Learn more about Conshohocken Physical Therapy by visiting us online at www.conshypt.com.