Plantar Fasciitis

The plantar fascia is a fibrous band-like structure that runs from the heel bone to the toes along the long arch of the foot.  Irritation of the plantar fascia where it starts at the base of the calcaneus (heel bone) is the condition known as plantar fasciitis or plantar fasciopathy.

Causes

This is an overuse injury and there is a saying that every runner will at one point in their life have plantar fasciitis. Certain anatomic foot variants may alter the biomechanics of the foot and predispose to overuse.  New training surfaces, shoes, programs, etc may contribute to increased load on the plantar fascia. A calcaneal heel spur is a secondary change from plantar fasciitis, it does not cause plantar fasciitis as is often thought.

Symptoms

Symptoms include pain along the inside aspect of the bottom of your heel.  The pain is often worst in the morning with the first few steps out of bed.  The pain may develop at the start of a run and in the early stages may improve with activity only to return at night or the next day.

Treatment

Procedural options for plantar fasciitis include regenerative-type injections (such as platelet-rich plasma [PRP] or stem cell injections) that can theoretically provide long lasting pain relief and improved function by stimulating the body’s own natural healing response.  There is some evidence that needling the fascia alone can stimulate bloodflow and healing. A procedure called Tenex can be done under ultrasound as well which uses a small oscillating needle to debride (suck out) the damaged parts of the fascia.

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