The plantar fascia is a fibrous band that runs lengthwise along the bottom of the foot from the heel to the ball of the foot. The plantar fascia supports the longitudinal arch and is essential for toe-off Inflammation of this structure is called plantar (bottom of the foot) fasciitis.

Symptoms

• pain in the bottom of the foot from the heel into the arch
• more intense pain upon arising in the morning and after prolonged sitting
• discomfort at the start of a run, subsiding during the run and recurring later

Causes

• high arched feet
• flat feet (overpronator)
• shoes (excessive wear)
• training errors (increase mileage/intensity too fast)

Treatment

• Eliminate the cause.
• Decrease running by 25-50 percent depending on the severity of symptoms; substitute with non-weight bearing cross training (cycling, swimming, pool running).
• Ice the site: Freeze a can of water (soda cans are too weak) and roll the frozen can under the foot from the heel to the ball for 10 to15 minutes 2 to 4 times per day.
• Anti-inflammatory medications: If you are able to tolerate them, anti-inflammatory
  medications (such as ibuprofen, naproxen) can help relieve inflammation and pain.

Take these medications with food and as directed on the bottle; check with your
physician if you are taking other medications or have any medical conditions.

• Devices: arch supports, heel cups, orthotics (custom-made arch support) may be helpful in decreasing pain and stress on the plantar fascia.
• Strengthening and stretching exercises for the calf and foot muscles.
• Calf stretch: typical Achilles stretches, hold 20-30 seconds. Repeat 5-10 times per day.
• Plantar fascia stretch: pull your toes up to stretch the bottom of your foot. Hold 20-30 seconds. Repeat 5-10 times per day.
• Towel curls: with your heel on the floor and your toes on the edge of a small towel, curl your toes to pull the towel under your foot. Repeat 5 times.
• Leg strength: put a weight around your foot. Point your foot up (10 reps), down, in and out. Repeat each set of 10 repetitions three times.
• Foot massage: roll your foot over a golf ball, rolling pin or similar device to help stretch the fascia, especially following activities. You can also use your thumbs to massage and stretch the fascia.
• Shoe maintenance: replace broken down running and exercise shoes before they cause problems. Make sure that the shoes that you wear during the remainder of the day are in good shape and provide adequate cushioning and arch support.
• Rarely, a cortisone injection may be needed to decrease symptoms.

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For more information or to schedule an appointment over the phone with a Trinity Clinic Orthopedic and Sports Medicine physician, please call (903) 510-8840.