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Plantar Fasciitis

The plantar fascia (a connective tissue structure) stretches from the toes and ball of the foot, through the arch, and connects to the heel bone in three places: outside, center and inside. Normally it helps the foot spring as it rolls forward. It also provides support for the arch of the foot. The plantar fascia helps keep the foot on track, cutting down on oscillation.

When the foot over-pronates (rolls to the inside) the plantar fascia tries to stabilize it and prevent excessive roll. In time, the inside and sometimes center connections are overstressed and pull away from their attachments. The first sign is usually heel pain as you rise in the morning. When you walk around, the pain may subside, only to return the next morning. Inflammation and increased soreness are the results of long-term neglect and continued abuse.

A heel bone spur may develop after a long period of injury when there is no support for the heel. The plantar fascia attaches to the heel bone with small fibers. When these become irritated they become inflamed with blood containing white blood cells. Within the white blood cells are osteoblasts which calcify to form bone spurs and calcium deposits. The body is trying to reduce stress on that area by building a bone in the direction of stress. Unfortunately, these foreign substances cause pain and further irritation in the surrounding soft tissue.

Symptoms:

Heel pain, usually on inside of forward part of heel. It’s worst in the morning and eases as it gets warmed up.

Treatment:

  • After pain starts, but before inflammation, rest 4-5 days.
  • Ice massage 10 minutes, getting area quite cold. Let it “warm up” 20 minutes then ice again.
  • Build up an arch support system in your shoes. Try to equalize the pressure of your body weight throughout your arch and away from the plantar area. Use a “cobra pad” or other device that supports the arch but releases pressure on the painful area. If homemade supports do not work, see a podiatrist about custom orthotics.

To build Foot Strength:

The “toe squincher” exercise can help develop foot strength that will also support the foot. It takes several weeks for this to take effect. This is another injury that allows for running as you heal, but stay in touch with your doctor. The “toe squincher” seems to stretch the plantar tendon and balance the pulling effect of muscles that pull the tendons on the top of the foot. Point your toes, then contract the muscles very hard for 7-10 seconds. Relax. Do this 5-10 daily, throughout the day. Don’t be surprised if the muscles cramp when you do it; it merely shows that the muscles are weak or tired or need work.

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