Plantar Fasciitis: Understanding, Treating, and Collaborative Care

Plantar fasciitis is a common and often debilitating condition characterized by inflammation of the plantar fascia, a thick band of tissue that runs from the heel to the toes, supporting the arch of the foot. It’s a leading cause of heel pain, particularly among athletes, individuals with high-impact lifestyles, and those with foot structure abnormalities.

What Causes Plantar Fasciitis?

Plantar fasciitis occurs due to repetitive strain or microtears in the plantar fascia, which can be caused by:

- Overuse, especially in runners or those standing for extended periods.

- Biomechanical issues like flat feet, high arches, or an uneven gait.

- Inappropriate footwear, particularly shoes with inadequate arch support.

- Excess body weight, which increases stress on the foot's structures.

Signs and Symptoms

- Sharp, stabbing or burning pain in the heel, especially during the first steps in the morning or after prolonged rest.

- Pain that worsens after exercise or activity rather than during.

- Tenderness along the sole of the foot, often localized near the heel.

Treatment Options

1. Conservative Treatments

Most cases resolve with non-invasive interventions:

- Stretching and Strengthening Exercises: Stretching the calf, Achilles tendon, and plantar fascia can reduce strain and improve flexibility.

- Functional Foot and Gait Assessment in order to correct and improve biomechanics, through specific Rehab or exercise

- Graston Technique to associated tight muscles and to PF or intrinsic foot muscles.

-Dry Needling to associated soft tissue structures

-Foot adjustments, manipulations in order to promote and assist optimal foot movement

-Change in Shoe’s and running or training shoes.

- Orthotics and Supportive Footwear: Custom insoles or well-cushioned shoes help redistribute pressure and provide arch support.

- Ice and Anti-Inflammatory Medications: Reduces swelling and alleviates pain.

2. Advanced Therapies

For persistent cases, advanced treatments may be necessary:

- Shockwave Therapy: A non-invasive treatment that uses sound waves to stimulate healing in the plantar fascia. Studies have shown this method effectively reduces pain and promotes tissue repair.

- Dry Needling: By targeting trigger points in the fascia and surrounding muscles, dry needling can release tension and enhance blood flow to the affected area.

- Prolotherapy Injections: This regenerative injection therapy stimulates the body’s natural healing processes. It’s particularly effective for chronic cases by promoting tissue repair and reducing inflammation.

3. Surgical Interventions

When conservative and advanced therapies fail, surgery may be considered:

- Bone Spur Removal: If a bone spur is contributing to chronic irritation of the plantar fascia, its removal may be necessary.

- Plantar Fascia Release: In severe cases, a portion of the plantar fascia may be surgically cut to relieve tension. (very uncommon)

Collaboration with Podiatrists

We prioritize an interdisciplinary approach, working closely with podiatrists to ensure comprehensive care:

1. Diagnosis and Biomechanical Assessment: Podiatrists provide specialized insights into the root causes of plantar fasciitis, including gait analysis.

2. Custom Orthotics: Collaborative designs ensure tailored solutions for individual needs.

3. Integrated Treatment Plans: Combining podiatric expertise with advanced therapies like shockwave and needling enhances outcomes.

4. Surgical Coordination: In cases requiring surgery, podiatrists and orthopedic surgeons collaborate for optimal results.

Preventing Plantar Fasciitis Recurrence

- Maintain a healthy weight to reduce strain on your feet.

- Invest in high-quality, supportive footwear, especially for athletic or high-impact activities.

- Incorporate regular stretching routines targeting the calves, Achilles tendon, and plantar fascia.

- Address biomechanical issues early with professional assessments and orthotics.

Conclusion

Plantar fasciitis can be challenging, but with the right combination of treatments and a collaborative care approach, recovery is achievable. By leveraging advanced therapies like shockwave therapy, needling, and prolotherapy while working closely with podiatrists, we ensure tailored, effective care for each patient.

If you’re struggling with persistent heel pain, contact us today to begin your journey toward relief and recovery!