Plantar fasciosis is a foot condition characterized by heel pain and pain in your plantar fascia-a strong and dense connective tissue structure on the sole of your foot that supports your foot arch.
This condition has historically been called plantar fasciitis because it was believed that plantar fascia inflammation was the principle underlying cause. Plantar fasciosis is a more accurate name
for this condition because it involves degeneration-microtears, cell death-of your plantar fascia, not inflammation. Active men between the ages of 40 and 70 are most commonly affected by this health
Far and away the most common cause of plantar fasciitis in an athlete is faulty biomechanics of the foot or leg. Faulty biomechanics causes the foot to sustain increased or prolonged stresses over
and above those of routine ground contacts. Throughout the phase of ground contact, the foot assumes several mechanical positions to dissipate shock while at the same time placing the foot in the
best position to deliver ground forces. With heel landing the foot is supinated (ankle rolled out). At mid-stance the foot is pronated (ankle rolled in). The foot is supinated again with toe-off. The
supination of the foot at heel strike and toe-off makes the foot a rigid lever. At heel strike the shock of ground contact is transferred to the powerful quads. During toe-off forward motion is
created by contraction of the gastroc complex plantar flexing the rigid lever of the foot pushing the body forward.
Symptoms of plantar fasciitis include pain in the heel of the foot. Some people complain of a sharp stabbing pain especially with walking. Others describe the pain as a dull ache after prolonged
standing. The pain of plantar fasciitis is often worst in the morning or following activity.
Plantar fasciitis is usually diagnosed by your physiotherapist or sports doctor based on your symptoms, history and clinical examination. After confirming your plantar fasciitis they will investigate
WHY you are likely to be predisposed to plantar fasciitis and develop a treatment plan to decrease your chance of future bouts. X-rays may show calcification within the plantar fascia or at its
insertion into the calcaneus, which is known as a calcaneal or heel spur. Ultrasound scans and MRI are used to identify any plantar fasciitis tears, inflammation or calcification. Pathology tests
(including screening for HLA B27 antigen) may identify spondyloarthritis, which can cause symptoms similar to plantar fasciitis.
Non Surgical Treatment
Most people who have plantar fasciitis recover with conservative treatments in just a few months. Pain relievers such as ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve) may ease the pain
and inflammation associated with plantar fasciitis. Stretching and strengthening exercises or use of specialized devices may provide symptom relief. These include physical therapy. A physical
therapist can instruct you in a series of exercises to stretch the plantar fascia and Achilles tendon and to strengthen lower leg muscles, which stabilize your ankle and heel. A therapist may also
teach you to apply athletic taping to support the bottom of your foot. Night splints. Your physical therapist or doctor may recommend wearing a splint that stretches your calf and the arch of your
foot while you sleep. This holds the plantar fascia and Achilles tendon in a lengthened position overnight and facilitates stretching. Orthotics. Your doctor may prescribe off-the-shelf heel cups,
cushions or custom-fitted arch supports (orthotics) to help distribute pressure to your feet more evenly.
Surgery may be considered in very difficult cases. Surgery is usually only advised if your pain has not eased after 12 months despite other treatments. The operation involves separating your plantar
fascia from where it connects to the bone; this is called a plantar fascia release. It may also involve removal of a spur on the calcaneum if one is present. Surgery is not always successful. It can
cause complications in some people so it should be considered as a last resort. Complications may include infection, increased pain, injury to nearby nerves, or rupture of the plantar fascia.