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jhopson88

What Brings About Painful Heel To Surface

Heel Pain

Overview

Plantar fasciitis is a condition characterised by damage and inflammation to the plantar fascia (i.e. the connective tissue on the sole of the foot forming the inner arch. This usually occurs at the attachment of the plantar fascia to the heel bone. Plantar fasciitis is the most common cause of heel pain seen in clinical practice. During walking or running, tension is placed through the plantar fascia. When this tension is excessive (often due to poor foot biomechanics such as flat feet or if it is too repetitive or forceful, damage to the plantar fascia can occur. Plantar fasciitis is a condition where there is damage to the plantar fascia with subsequent inflammation and degeneration. This may occur traumatically due to a high force going through the plantar fascia beyond what it can withstand or, more commonly, due to gradual wear and tear associated with overuse. Occasionally, a heel spur may develop in association with plantar fasciitis.



Causes

Far and away the most common cause of plantar fasciitis in an athlete is faulty biomechanics of the foot or leg. Faulty biomechanics causes the foot to sustain increased or prolonged stresses over and above those of routine ground contacts. Throughout the phase of ground contact, the foot assumes several mechanical positions to dissipate shock while at the same time placing the foot in the best position to deliver ground forces. With heel landing the foot is supinated (ankle rolled out). At mid-stance the foot is pronated (ankle rolled in). The foot is supinated again with toe-off. The supination of the foot at heel strike and toe-off makes the foot a rigid lever. At heel strike the shock of ground contact is transferred to the powerful quads. During toe-off forward motion is created by contraction of the gastroc complex plantar flexing the rigid lever of the foot pushing the body forward.



Symptoms

When plantar fasciitis occurs, the pain is typically sharp and usually unilateral (70% of cases).Heel pain worsens by bearing weight on the heel after long periods of rest. Individuals with plantar fasciitis often report their symptoms are most intense during their first steps after getting out of bed or after prolonged periods of sitting. Improvement of symptoms is usually seen with continued walking. Numbness, tingling, swelling, or radiating pain are rare but reported symptoms. If the plantar fascia continues to be overused in the setting of plantar fasciitis, the plantar fascia can rupture. Typical signs and symptoms of plantar fascia rupture include a clicking or snapping sound, significant local swelling, and acute pain in the sole of the foot.



Diagnosis

Physical examination is the best way to determine if you have plantar fasciitis. Your doctor examines the affected area to determine if plantar fasciitis is the cause of your pain. The doctor may also examine you while you are sitting, standing, and walking. It is important to discuss your daily routine with your doctor. An occupation in which you stand for long periods of time may cause plantar fasciitis. An X-ray may reveal a heel spur. The actual heel spur is not painful. The presence of a heel spur suggests that the plantar fascia has been pulled and stretched excessively for a long period of time, sometimes months or years. If you have plantar fasciitis, you may or may not have a heel spur. Even if your plantar fasciitis becomes less bothersome, the heel spur will remain.



Non Surgical Treatment

If you walk or run a lot, cut back a little. You probably won't need to stop walking or running altogether. If you have either flatfeet or a high arch, ask your doctor about using inserts for your shoes called orthotics. Orthotics are arch supports. You will need to be fitted for them. If you are overweight, losing weight can help lessen your heel pain. If your job involves standing on a hard floor or standing in one spot for long periods, place some type of padding on the floor where you stand.

Plantar Fasciitis



Surgical Treatment

If you consider surgery, your original diagnosis should be confirmed by the surgeon first. In addition, supporting diagnostic evidence (such as nerve-conduction studies) should be gathered to rule out nerve entrapment, particularly of the first branch of the lateral plantar nerve and the medial plantar nerve. Blood tests should consist of an erythrocyte sedimentation rate (ESR), rheumatoid factor, human leukocyte antigen B27 (HLA-B27), and uric acid. It’s important to understand that surgical treatment of bone spurs rarely improves plantar fasciitis pain. And surgery for plantar fasciitis can cause secondary complications-a troubling condition known as lateral column syndrome.



Stretching Exercises

While it's typical to experience pain in just one foot, massage and stretch both feet. Do it first thing in the morning, and three times during the day. Achilles Tendon Stretch. Stand with your affected foot behind your healthy one. Point the toes of the back foot toward the heel of the front foot, and lean into a wall. Bend the front knee and keep the back knee straight, heel firmly planted on the floor. Hold for a count of 10. Plantar Fascia Stretch. Sit down, and place the affected foot across your knee. Using the hand on your affected side, pull your toes back toward your shin until you feel a stretch in your arch. Run your thumb along your foot--you should feel tension. Hold for a count of 10.

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