Recent News Coverage Creates Awareness and Questions About Plantar Fasciitis

PR Log (Press Release) – Oct 12, 2009 – Chances are either you or someone you know has experienced the painful condition known as plantar fasciitis. It is an all too common problem that has sidelined many famous stars, like Tim Duncan and Shaquille O’Neil. Most recently it has been a buzz word on ESPN and sports blogs as New York Giants Quarterback, Eli Manning fell victim to this condition.

Experts estimate that it affects nearly two million Americans per year and will affect almost 10% of the American population in their lifetime.  

Plantar fasciitis is inflammation of the plantar fascia, a dense connective tissue structure that runs along the bottom of the foot from the heel to the area around the ball of the foot. Though referred to as one unit it is actually comprised of many thin layers that have to glide on and over each other for it to work together.

When that area gets inflamed the layers do not properly glide and as a result cause pain in the bottom of the foot.  The severity ranges, a relatively mild case can be isolated to one area of the foot, where a severe case can be felt from the heel to the ball of the foot.

Surgical success varies and can result in damage to the nerve, onset of infection and complete rupture of the plantar fascia. Conservative treatment should be considered prior to surgery.  

With a conservative approach, the goal of treatment is to decrease the initial inflammation associated with acute injuries by resting and icing the structure.

Going forward, the goal needs to be to continue to address the residual inflammation in the area as well as improve the range of motion.  Electric stimulation, ultrasound, iontophoresis or phonophoresis with 0.4% dexamethasone are indicated along with use of cold laser and stretching the gastrocnemius and soleus, which make up the “calf muscle”.  Additionally, deep friction massage should be used to improve the movement of the layers on each other and a custom orthotic may be indicated.

Be wary of treatment programs that address the plantar fascia alone, typically though it is the specific diagnosis and chief complaint, it is a symptom of a biomechanical issue elsewhere.  

Your back, hip, knee and ankle all affect the way your foot hits the ground and how you bear you weight through the foot and plantar fascia, just as shifting the load in your car affects the wear of your tires.

In most situations, plantar fasciitis is caused and is therefore a symptom of biomechanical issues elsewhere in the body such as tightness and strength deficits of the hip, knee and ankle need to be addressed.

These muscle imbalances cause the plantar fascia to be overloaded with forces it is not able to withstand causing injury.  Addressing just the plantar fascia and without addressing additional factors increase the chances of the reoccurrence and could make the situation chronic. The odds of successful pain relief are slim; if you do experience pain relief the chances of reoccurrence are high.

Christopher Stulginsky, PT is a 2003 graduate of the physical therapy program at the Rangos School of Health Sciences at Duquesne University in Pittsburgh, PA.  He has worked at The Johns Hopkins Hospital in Baltimore, MD and in various Sports Medicine clinics around the country. Currently, he is the managing partner or Ayrsley Town Rehabilitation, a physical therapy clinic in Charlotte, NC.

For more information please visit: www.ayrsleyrehab.com