What is it
The plantar fasciitis is a disease that is caused by inflammation of the plantar fascia, ie, the fibrous tissue surrounding the intrinsic muscles of the foot and leading from the calcaneus (heel) to the toes. This structure has an essential function in walking, as it is one of the main responsible for maintaining the plantar arch, absorbing and returning the energy produced when the foot hits the ground. In addition, it is responsible for protecting the metatarsals by avoiding excessive flexion of the fingers.
“There are many factors that can cause us a pain in the heel, from the fascia itself that is inserted in the heel bone, to the bursa that is between this bone and the musculature; the bone itself (due to a fracture or cyst), or the nerves that pass through this area and which, due to excessive compression, can lead to neuralgia, ”Rafael Navarro, general secretary of the General Council of Official Podiatry Colleges, explains to ArthritisCo.
One of the characteristics of plantar fasciitis is that this lesion is very painful. During the first six months, the pain is morning and appears when you get up and take the first steps. After the first six months, the pain becomes latent during all daily activities.
Therefore, it has a very negative impact on the quality of life because it does not allow us to perform the usual physical activity due to the pain it generates. This can also have emotional implications since there are many people who use sport to reduce anxiety and stress and in the face of plantar fasciitis, sports activity must be suppressed many times.
Plantar fasciitis is one of the most frequent pathologies treated in the podiatry office. In fact, between 20 and 30% of the population will suffer plantar fasciitis in some of their stages throughout life.
Juan Carlos Montero Arroyo, advertising and network member of the Professional College of Podiatry of the Community of Madrid (Copoma) , points out that behind plantar fasciitis there are general causes, such as for overweight, the degree of intensity of physical activity we perform or wear shoes that are not suitable.
In addition, other biomechanical causes may exist or appear due to the shape of the foot. For example, feet that have a very flattened plantar vault, those that have an increase in stiffness or shortening in certain muscles.
The main symptom of this lesion is the pain that occurs in the internal area of the heel, the part where the plantar fascia is inserted, and which usually manifests itself more intensely in the morning due to the morning stiffness of the fascia than by the Night is shortened.
The pain is usually accompanied by mild swelling, redness, and tenderness in the lower heel.
In the case of athletes, the pain will only appear in the morning and after the practice of sports activity so, in general, you can continue doing the activity.
Plantar fasciitis can be prevented. Montero Arroyo points out that using appropriate footwear, not exceeding the loading threshold of our plantar fascia and sometimes using podiatry templates we can prevent this problem.
In addition, Navarro points out that by reducing excess weight, as well as applying a podiatric treatment to a valgus flat foot or an asymmetry of the lower limbs, and performing stretching of the posterior musculature of the leg, we can help avoid it.
“In the case of women, carrying out a transition from heels to flat shoes slowly” also helps prevent this condition, says Navarro.
The diagnosis of plantar fasciitis is carried out by performing a medical history and a physical examination.
First, the specialist will ask the patient how long it has been with the pain and if there was any factor that triggered it. Subsequently, a clinical examination and a gait study will be performed to see factors that may increase the stress and tension of the plantar fascia, such as having a posterior musculature of the shortened leg, a valgus flat foot, a gait with the feet pronation, an asymmetry of lower limbs, etc.
Finally, an x-ray will be done to see if there is a spur, cyst or fracture; and, finally, an ultrasound will be performed to see the state of the fascia, the calcaneal bursa, and the nerve branches. With this test the specialist will be able to see if the fascia is thickened, scarred or torn and how is its insertion in the heel.
The first step to be taken before plantar fasciitis is rest.
From there, the initial treatment usually consists of the combination of anti-inflammatories with different physiotherapy treatments aimed at relieving the inflammation of the fascia in the acute phase of this disorder.
It is important to go to the podiatrist when the first symptoms appear, since applying the treatment early ensures that the recovery of the lesion is better. In the consultation, the specialist will determine the most appropriate treatment: functional bandages, stretching, review of laser footwear, custom podiatry insoles, physiotherapy, etc.
Is it more frequent in sportspeople?
Plantar fasciitis can affect 1 in 6 people, but there are factors that can increase the risk of having this pathology, such as those that involve excessive tension and stress of the fascia.
Practicing sports, especially physical exercise that generate a greater impact on the feet, can be a risk factor to suffer from this pathology; However, plantar fasciitis can affect anyone regardless of their activity.
Montero explains that the sports that have the greatest impact on the feet are running, basketball or volleyball, among others.
The general secretary of the General Council of Official Podiatrist Colleges indicates that when fasciitis is prolonged over time it can cause a calcaneal spur.
“The inflammation in the area where the fascia is inserted into the calcaneus causes a decalcification of the bone that originates the spur,” adds Navarro.