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Plantar fasciitis is a partial tear, or microtear, of the plantar fascia. The plantar fascia is similar to a ligament and extends from the heel through the sole of the
foot to the toes. The symptoms of plantar fasciitis are typically pain in the sole of the foot or heel with the first few steps after getting out of bed in the morning.
The pain is also noted in the feet after prolonged standing. Fortunately fasciitis usually responds well to conservative care only rarely requiring surgery.
Methods of Treatment:
1) Calf stretching exercises done in a gentle prolonged fashion lasting one to two minutes per stretch. The stretch is done both with the knee
straight as well as the knee bent which stretches both the superficial and deep muscles of the calf. The plantar fascia itself can be stretched while doing the
calf stretch by lifting the heel off the ground and pushing through the forefoot.
2) Gently massage the sole of the foot and plantar fascia before getting out of bed. A gentle calf stretch can also be done while still in bed
to minimize the initial pain of the first morning steps.
3) Avoid prolonged walking and standing.
4) Ice massage of the sole of the foot can be done using common household items such as a can of frozen orange juice or ice in a styrofoam cup.
5) The intrinsic muscles of the foot can be exercised by performing toe curls. Curl the toes and hold that isometric position for five seconds then
relax. This should be done in two sets of twenty repetitions. The toes can also gather up paper or cloth in a toe curling exercise.
6) Oral anti-inflammatory medication, either prescribed or over the counter, may be helpful.
7) Heel cushions and arch supports are often needed.
8) FABS, a type of plantar fascia strap, may be used.
For stubborn cases of plantar fascia that do not resolve after a concerted effort of the above recommendations for an appropriate period of time, custom made orthoses
or shoe modifications may be required. Other potential treatments include night splinting or short leg casting for four to six weeks.
Local injections with cortisone type medications may be helpful but should be employed judicially.
For long standing recalcitrant cases, further work up such as bone scan or laboratory studies may be indicated. Surgery may be performed as a last resort
in chronic plantar fasciitis.
We hope this information helps in resolving plantar fasciitis as quickly as possible.
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