Issue Date: May 20, 2007
Support your feet
You can minimize the pain of plantar fasciitis.
Once plantar fasciitis occurs, you're already behind, so take care of your feet now.
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In my practice as a sports medicine doctor, one of the most common foot problems I encounter is plantar fasciitis. Although the term sounds funny, the problem isn't. For those who suffer from it, the pain it causes can disrupt their daily routine.
Plantar fasciitis is a condition that occurs when the connective tissue on the bottom of the foot (called plantar fascia) becomes inflamed. The fascia lends support to the arch and structures of the foot. It extends from the heel to the toes, so you can imagine how problematic it is when it becomes irritated. The pain from plantar fasciitis occurs on the bottom of the foot near the heel and is described as sharp or burning. It's worse first thing in the morning and generally gets better the longer someone remains on his feet. The pain can recur, usually after the person has been off his feet for a protracted period. It can occur in one or both feet, but when it strikes, it's memorable.
What causes the fascia to become irritated? Lots of things can set you up for problems. For starters, the fascia supports the arch, so anything that places added burden on it can cause tiny tears in the tissue. These tiny tears lead to an inflammatory reaction and, eventually, the symptoms of plantar fasciitis. Obesity or rapid weight gain, high-impact exercises like jogging and basketball, diabetes (for reasons that aren't clear), shoes that have no arch support or thin, hard soles that don't support the feet, or underlying foot problems (like high or low arches) all can overburden the plantar fascia. Another major contributor to the problem is having tight Achilles tendons. This decreases the normal range of motion for the feet so that when these tendons are stretched past this limited range, an undue stress is placed on the fascia. This phenomenon explains why the pain is worse in the morning: The foot remains in a contracted position overnight, and when it's "stretched" first thing the next morning, the pain strikes.
The good news about plantar fasciitis is that it generally goes away. The bad news is that it can take a long time. The symptoms last anywhere from a few months up to a couple of years, so it's important that those who have it employ a few tricks to minimize its effect on their lives. Treatment includes consistently stretching the plantar fascia and the Achilles tendons (see box at left). Additional home remedies to try include icing feet at the end of the day, taking over-the-counter anti-inflammatories such as ibuprofen and wearing the right footwear (shoes with good arch support; no hard heels or soles).
For those who continue to have problems in spite of these maneuvers, talk with your doctor. After taking a quick history and doing an exam to rule out other problems, chances are, she'll refer you to a physical therapist, who can show you more targeted stretching and strengthening exercises based on the shape of your foot. There are even special splints and boots that can be used to help stretch out the tissues in the lower leg and foot.
You can help prevent plantar fasciitis by understanding what predisposes you to the problem and taking corrective action now. Once it occurs, you're already behind, so take care of your feet now. After all, your plantar fascia work hard every day to support your feet, so why not give them the proper support they need to stay healthy?
Tedd Mitchell, M.D., president andmedical director of Dallas' Cooper Clinic, writes HealthSmart every week.
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Ease plantar fasciitis
Here's an exercise tip to help ease plantar fasciitis:
Sit on the floor with your legs out in front of you, toes pointing up. Roll a towel into a tube lengthwise. Holding the ends in each hand, place the towel over the balls of your feet. Apply gentle traction so that you feel your feet and Achilles tendons getting a nice stretch.
Hold for 30 seconds, relax, and do it again and again.
Over time, this exercise helps to improve the flexibility of the Achilles tendons and plantar fascia, which helps alleviate symptoms.
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