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Plantar Fasciitis (often misspelt as 'Fascitis') also called "policeman's heel", is a painful inflammatory condition causing heel pain and in some cases heel spurs.
It can also result in arch pain. It is the most common form type of foot pain. At least half of Brittain's over 50 population will suffer from this condition at some stage!
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The pain usually is felt on the underside of the heel and is often most intense with the first steps when getting out of bed in the morning. Plantar Fasciitis is presented by a sharp stabbing pain at the bottom or front of the heel bone.
In most cases, the pain is more severe when getting up, following periods of inactivity (e.g. sleep or sitting). After walking for a while the sharp pain subsides and turns into a dull ache. Heel pain can also develop after long walks, standing for hours, sports or running.
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The main cause of Plantar Fasciitis is over-pronation. This means that with every step we take our ankles roll inward and arches lower. Other factors that play a role include: age, recent weight gain, walking or standing on hard surfaces for long periods of time and last but not least tight muscles and ligaments. In particular tight calf muscles and achilles tendons will contribute to Plantar Fasciitis.
Over-pronation is a common condition, affecting 70% of the UK population: during walking our arches lower and with every step we take the plantar fascia (band of fibrous tissue under the foot) is being overly stretched resulting in inflammation, micro-tearing and pain at the attachment of the fascia into the heel bone. In some cases pain is also felt under the foot, in the arch area.
Continuous pulling of the fascia at the heel bone, eventually may lead to the development of a bony growth on the heel. This is called a Heel Spur. It should be noted that spurs are a mere symptom of Plantar Fasciitis; the spur itself does not cause any pain, but rather the inflamed tissue around the spur.
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Summary:
Definition: Plantar Fasciitis = inflammation of the plantar fascia
Symptoms: pain in the heel, especially in the morning
Causes: over-pronation, fallen arches, tight calf muscles,
Treatment: stretching exercises and orthotics
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There are a number of treament options availabe for Plantar Fasciitis. Some more effective than others. Medical treatments include surgery, shockwave therapy and cortisone-steroid injections. In most cases such measures are not necessary and doctors will recommend less invasive treatments options first, before committing to surgery, injections etc.
Research has shown that Plantar Fasciitis can be treated effectively by wearing orthotic insoles and by doing some simple, daily exercises. In addition, one should minimise walking or standing, allowing the inflamed tissue to heal faster. You can also take anti-inflammatory medication (e.g. ibuprofen) and apply ice onto the sore heel for about 5-10 minutes (twice a day).
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Orthotic insoles are now used as a first treatment option for Plantar Fasciitis by podiatrists, chiropodists and physiotherapists across the UK. Orthotics are corrective insoles and they should not be confused with spongy rubber footbeds, gel heel cups etc available from chemists and supermarkets. Most of these products simply provide cushioning, they do not, however, provide any biomechanical correction!
Orthotics on the other hand re-align the feet, ankles and lower leg. Many of us have quite a normal-looking arch when sitting or even standing. However, it is the impact of weight bearing during walking that has a profound effect on the arches and the ligaments in the foot. With every step we take the arches lower (a lot in some people, a little in others) and this puts strain and tension on the plantar fascia, which in turn leads to inflammation and pain. Orthotics support the arches and release excess strain on the plantar fascia, allowing the inflamed tissue to heal and preventing further damage and micro-tearing of the tissue.
To be effective the orthotic doesn't have to be an expensive, custom-made device. A comprehensive Heel Pain study by the American Orthopaedic Foot and Ankle Society found that by wearing standard pre-made orthotics and doing a number of daily exercises, 95% of patients in this study experienced substantial, lasting relief from their heel pain symptoms! A recent study in Canada also confirmed the effectiveness of low-cost orthotics in the treatment of plantar fasciitis.
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