Wednesday, September 1, 2010

Battles with Plantar Fascitis

Oh... if it weren't everything I'm going through right now it would be funny. A few years ago my heel was swollen like a grapefruit. It didn't really hurt much. So I wedged my shoe on and did a full day's worth of presentations... standing. That's what consultants do. We gut it out in order to get paid. No guts/No work = no pay.

For more on how I train people with PF... contact me directly.

Tonight was a forced off night as my heels, achilles and arches hurt like crazy. Tomorrow a swim, water run, lift in the AM.

Here is a taste of what I'm going through. Remember... I walk 2.367 miles a day to and from the office plus walking for meetings (a lot) and food/ice water.

Plantar fasciitis is irritation and swelling of the thick tissue on the bottom of the foot.
The most common complaint is pain in the bottom of the heel. It is usually worst in the morning and may improve throughout the day. By the end of the day the pain may be replaced by a dull aching that improves with rest.
Most people complain of increased heel pain after walking for a long period of time.
Conservative treatment is almost always successful, given enough time. Treatment can last from several months to 2 years before symptoms get better. Most patients will be better in 9 months.
Initial treatment usually consists of:
Anti-inflammatory medications
Heel stretching exercises
Night splints
Shoe inserts

Got 'em all.

If these fail, putting the affected foot in a short leg cast (a cast up to but not above the knee) for 3-6 weeks is very often successful in reducing pain and inflammation. Alternatively, a cast boot (which looks like a ski boot) may be used. It is still worn full time, but can be removed for bathing.

Some physicians will offer steroid injections, which can provide lasting relief in many people. However, this injection is very painful and not for everyone.

In a few patients, non-surgical treatment fails and surgery to release the tight, inflamed fascia becomes necessary.

Causes **ALL**
The plantar fascia is a very thick band of tissue that holds up the bones on the bottom of the foot. This fascia can become inflamed and painful in some people, making walking more difficult.
Risk factors for plantar fasciitis include:
Foot arch problems (both flat foot and high arches)
Sudden weight gain
Tight Achilles tendon (the tendon connecting the calf muscles to the heel)
A typical patient is an active man age 40-70.
This condition is one of the most common orthopedic complaints relating to the foot.
Plantar fasciitis is commonly thought of as being caused by a heel spur, but research has found that this is not the case. On x-ray, heel spurs are seen in people with and without plantar fasciitis.

Tests & diagnosis
Typical physical exam findings include:
Mild swelling
Tenderness on the bottom of the heel
X-rays may be taken to rule out other problems, but having a heel spur is not significant.

Nearly all patients will improve within 1 year of beginning non-surgical therapy, with no long-term problems. In the few patients requiring surgery, most have relief of their heel pain.

Maintaining good flexibility around the ankle, particularly the Achilles tendon and calf muscles, is probably the best way to prevent plantar fascitis.

1 comment:

  1. This is a really helpful post Rob. This is an ailment that I dread. I haven't yet been afflicted with it - probably because I'm not pushing myself too hard - but it's something that's often in the back of my mind. Thanks for sharing some of these insights! Great blog, by the way. I'm going to link it to mine which is also on -

    Take care!


    HEHS, Class of '87!