PLANTAR FASCITIS

Plantar Fascitis is a painful inflammatory process of the plantar fascia ,the connective tissue on the sole of the foot.The plantar fascia is a thick fibrous band of connective tissue originating on the bottom surface of the calcaneus (heel bone) and extending along the sole of the foot towards the toes.it supports the arch of the foot.it is the most common causes of the heel pain.It is often caused by overuse of the plantar fascia or arch tendon of the foot.by the over strain of the plantar fascia,it gets weak ,swollen and inflamed.sometimes small tears may also be occur.this will causes the severe pain.The pain is mainly seen in the anterior part of the calcaneous.It is common in middle aged people.it also occur in younger people whose are on their feet a lot.It can also be termed as "policeman's heel".

Causes of Plantar Fascitis: 

 It is mainly caused by over straining of the Plantar Fascia.the straining may occur in different ways and its finally lead to inflammation ,pain,swelling etc.

• flat foot.
• calcaneal spur.
• over straining like long walk,running etc. especially on hard surface.
• bare foot walk.
• feet roll inward too much while walking.
• over wight.
• improper shoes,
• high heeled foot wears.
• weak calf muscles etc.

Symptoms of Plantar Fascitis: 

Symptoms are all same as symptoms due to calcaneal spur.like

• pain when the patient take their first steps after they get out of bed or sit for a long time.and after that pain reduced and a dull type of pain persist.
• pain aggravated while climbing steps,long walk etc.
• stiffness and sometimes numbness may occur.
• slight inflammatory symptoms like swelling etc.

Aggravating Factors:

• long walk and running.
• bare foot walk.
• improper foot wear.
• lack of rest etc.

How to diagnose: 

The diagnosis of plantar fascitis is usually made by clinical examination alone.Check the feet and watch the patients stand and walk.Ask the patient about medical history, physical activity, foot pain symptoms and etc.if needed advice the patient to take X-Ray,diagnostic ultrasound and MRI. to rule out other possible causes of heel pain.
On Examination can find the location of pain,tenderness,etc

How to prevent Plantar Fascitis:

• give proper rest.
• increase the strength of calf muscles through exercise.
• use proper fitted footwear with having heel arch and support.
• avoid bare foot walk especially in hard floor.
• avoid high heeled foot wear.
• reduce weight.
• avoid standing for long.
• take a warm up before every exercise.
• avoid standing for long.
• avoid excessive intake of hot and spicy foods. etc

 Treatments for Plantar Fascitis: 

Treatment options for plantar fascitis include rest, massage therapy, stretching, night splints, physical therapy, cold therapy, heat therapy, orthotics, anti-inflammatory medications, injection of corticosteroids and surgery in refractory cases. Also, in some cases, massaging of the inflamed location serves as a temporary relief.

it don't have a magical cure, but can cure the pain,inflammation and eventually get rid of them.

Treatment methods are described in four steps.before starting the treatment one should understand that primarily avoid possible causes of the diseases.Treatments are:

• Life style management.
• Exercise.
• Medicine
• shoe recommendations
• taping or strapping to rest stressed muscles and tendons.
• orthopaedic molds.
• shoe inserts 
• Extra Corporeal Shock Wave Therapy(ESWT)
• Surgery.

1-LIFE STYLE MANAGEMENT: 

Avoid causative factors emphasis to given to preventive measures.add proper exercises and yoga like therapies in life style.

avoid junk foods,hot and spicy food,which will ultimately lead to obesity, diabetic etc.

use of proper shoes,well fitted not high heeled, etc.

reduce obesity.

give proper rest after work or exercise.

2-EXERCISES: 

All efforts are carried out to reduce the stress and over pressure on weight bearing joints especially heel.

Mainly three types of exercise are used for this disease.

1. Stretching of Calf Muscles.
2. Rolling Exercises.
3. Out stretching of legs.

Stretching of Calf muscles: 

Place your hands on a wall. Extend one foot behind you with your knee straight and place the other foot in front of you with the knee bent.Push your hips towards wall and hold stretch for 10 seconds. you should fell a pull on calf muscles.repeat it for 20 times for each foot.

Plantar Fascia Stretch: 

Perform this exercise in the morning before you have done any standing  or walking. Cross injured leg.grasp toss and gently pull them toward you.if you cant reach toes, then warp a towel around them and pull on the towel. hold stretch for 10 sec and repeat several times for each foot.

plantar fascia stretch

Rolling Exercise:

the person is advised to sit on a chair and a tennis ball or marbles are placed below the sole and is rolled from front to back.

rolling exercises

Out stretching of the legs:

one of the legs is put forward by standing position. Meanwhile another leg should remain in straight line with other leg. back is kept in erect position and knee is bent forward so that the leg below the knee is stretching out for a few minutes..repeat this for other leg also.

Shoe recommendations:

Generally a Plantar Fascitis develops when proper care is not given to the foot and heels.

• choose the new shoes that are the right size.
• walk around before you buy shoes.-make sure that you can wiggle your toes freely inside of the shoes.and also sure that have enough space between your tallest toe and the end of the shoe.
• use orthotic inserts inside the shoes.- use heel cups, insoles.
• avoid high heeled shoes and foot wears.

Orthopaedic molds.: 

Orthopaedic molds are quite effective in treating heel spurs.they are easily available in market.place these molds under the heel in your shoes on regular basis.

it will give relief.

Other methods:

• apply ice pack for 10 to 15mts at least twice a day.or rolling your foot over an iced can.or bottle.
• get some rest.wear night splints.