December 24, 2015

Fact: 10% of the population in the United States complain of heel pain during their lifetime with a majority of these people being active adults.
An unfortunate statistic to consider, especially when we think about the pain people are enduring or trying to endure.

What is Plantar Fasciitis?

Plantar Fasciitis is the Latin term for "inflammation of the plantar fascia". The plantar fascia is a thick, fibrous ligament that runs under the foot from the heel bone to the toes. It forms the arch of the foot and functions as our natural shock-absorbing mechanism. Unlike muscle tissue, the plantar fascia is not very elastic and therefore is very limited in its capacity to stretch or elongate.
Herein lies the problem: when too much traction is placed on the plantar fascia (for various reasons) micro-tearing will occur, resulting in irritation, inflammation and pain.
Plantar Fasciitis usually causes pain under the heel. However some people may experience pain under the arch of the foot. Both heel pain and arch discomfort are related to Plantar Fasciitis, with heel pain being far more common than arch pain.

What is a Heel Spur?

A heel spur is a bony growth at the front/underside of the heel bone. This type of calcification is also referred to "calcaneal spur" (calcaneus is Latin for heel bone). The reason for the development of a spur is that the body 'responds' to the constant traction and pulling from the plantar fascia ligament away from the heel bone. The ligament itself cannot become any longer, so instead the bone will 'assist' the ligament and grow.
A heel spur will show clearly on an X-Ray of your foot. After diagnosis of the Plantar Fasciitis, some doctors will recommend you have X-Rays taken. However, it should be noted that spurs are not painful. They are not the problem. Pain is only caused because of inflammation of the tissue surrounding the heel spur.
It is interesting to note that most people suffering from Plantar Fasciitis pain do not have a heel spur! And vice-versa, there are people with a spur under one or both heels, but they have never experienced any foot pain. Spurs take many years to develop, they can also be found at the back of the heel (near the Achilles Tendon) or in other parts of the body.

Symptoms, is the pain worse in the morning or after sitting?

Heel pain is in most cases experienced in the centre of the underside of the heel, or at the front or sides of the underside of the heel. The pain is more intense with your first steps out of bed in the morning or after sitting for a while. The reason for this is that during rest our muscles and ligaments tend to shorten and tighten up. The tightening of the plantar fascia means more traction on the ligament making the tissue even more sensitive. With sudden weight-bearing the tissue is being traumatised, resulting in a stabbing pain.
After walking around for a while the ligament warms up, becomes a little bit more flexible and adapts itself, making the pain go away entirely or becoming more of a dull ache. However, after walking a long distance or standing for hours the pain will come back again.
To prevent the sudden sharp pain in the morning or after sitting, it is important to give the feet a little warm-up first with some simple exercises. Also, any barefoot walking should be avoided, especially first thing in the morning, as this will damage to the plantar fascia tissue.
Wearing Compression Socks can also help by keeping the muscles and ligaments warm and supported. The compression will also help reduce inflammation and Swelling.

What are the main causes of the pain?

Plantar Fasciitis is simply caused by overstretching of the plantar fascia ligament under the foot. So why is the ligament being overstretched? There are different factors:

  • Over-use: too much sports, running, walking or standing for long periods (e.g.  standing at work)
  • Weight gain: our feet are designed to carry a 'normal' weight. Any excess weight places great pressure on the bones, nerves, muscles and ligaments in the feet, which sooner or later will have consequences. Even pregnancy (in the last 10 weeks) can cause foot problems!
  • Poor or High Inflammatory Diet:As inflammation of the plantar fascia is often the course of pain, a poor diet or a diet that promotes inflammation will no doubt make things worse. Poor Diet is also the course of weight gain.
  • Age: as we get older ligaments become tighter & shorter and muscles become weaker; the ideal circumstances for foot problems
  • Unsupportive footwear: 'floppy' shoes with no support as well as thongs affect our walking pattern
  • Walking barefoot: especially on hard surfaces like concrete or tiles
  • Low arch/flat feet or over-pronation: an important contributing factor to Plantar Fasciitis is 'excess pronation'(or over-pronation). This is a condition whereby the feet roll over, the arches collapse and the foot elongates. This unnatural elongation puts excess strain on the ligaments, muscles and nerves in the foot.

When the foot is not properly aligned, the bones unlock and cause the foot to roll inward. With every step taken your foot pronates and elongates, stretching the plantar fascia and causing inflammation and pain at the attachment of the plantar fascia into the heel bone. Re-alignment of the foot should therefore be an important part of the treatment regime. 

Treatment Options

There are a many ways to treat Plantar Fasciitis, some are effective, some less, some expensive and some free. There are short-term fixes and long term treatments.  Listed below are the most common forms of treatment:

  • Cortisone-steroid injections: anti-inflammatories injected into the heel. 
  • Shockwave therapy: ESWT Treatment can be effective. 
  • Acupuncture: this is an alternative treatment method.
  • Trigger-point massage: trigger points are tight knots in the muscles 
  • Compression Sock/Sleeves and Night splint: wearing these during the day and at night while sleeping. 
  • Surgery: plantar fascia surgery only as a last resort!

Armstrong Amerika offers many options for treating Foot and Heel Paint, one of our customers most popular options is our "Miracle Foot & Heel Pain Relief Kit".

Best Wishes 

Armstrong Amerika