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Waking Up with Heel Pain? Plantar Fasciitis may be the Culprit

Plantar Fasciitis, commonly described as heel pain, is a common foot condition that occurs in about 2 million Americans annually. The plantar fascia is a thick band of tissue that connects from the heel to the ball of the foot. The plantar fascia helps support your arch. Secondary to multiple factors that we will later go over, the plantar fascia can become inflamed and/or torn creating pain. Pain can be felt anywhere along this band of tissue.

You may be more prone of having this condition if you are over the age of 40, however it can happen at any age. Here are some other factors that could potentially lead to a flare up: prolonged standing, rapid increase in duration and activity levels, decreased calf muscle flexibility, increased body weight, or being flat footed. A lot of people will notice pain when taking the first few steps after waking in the morning or when going from sitting to standing. In both cases your feet are placed in a position where the toes point downward (away from a neutral position for you ankle) for an extended period of time. This shortens the calf muscle and plantar fascia. When they are shortened and then stretched, like when standing back up from a seated or lying position, it may cause discomfort. Other common activities where you may notice increased discomfort are: prolonged standing, after intense weight-bearing activities such as running, climbing stairs, going barefoot, or wearing unsupportive shoes.

If you think you may have plantar fasciitis a visit to you doctor and a quick referral would give you the ability to start physical therapy. Physical therapy is able to help assist you in recovery by working on strength, mobility, and using modalities to decrease pain and inflammation. This may consist of specific eccentric exercises. Eccentric exercises load the calf tendon and the plantar fascia. They may also suggest the use of a night splint to keep from tightness after having the ankle in below neutral position for an extended period of time. Some modalities used for pain and inflammation may be ice and/or iontophoresis. Heel cups, cushioned, supportive shoes and/or taping may provide short term relief. However, plantar fasciitis is not an ailment that can be quickly fixed and often an exercise program can take up to 12 weeks.

Help prevent or manage this condition. Choose supportive shoes. Physical therapists are able to make recommendations for proper footwear by looking at the structure of your feet when standing and walking. Replace your shoes regularly as the cushion and arch support will wear down over time. If you stand on a hard surface for a prolonged period of time consider investing in a cushioned mat to stand on. Exercise wisely. Do not increase your activity all at once, progress into it. For running it is important to only increase your training 10% per week. Also only increase one of the following variables at a time; distance, speed, or total load (hills/strength training). Remember to always give your body adequate time to recover from activity. Make an effort to stretch your calves and feet before and after running or walking. Again for running, an easy measure to know if you have good flexibility is to stand facing a wall with your big toe 4 inches away from it. Then, bend at your knee attempting to touch it to the wall. You should be able to achieve your knee touching the wall without your heel rising off the floor. Finally, maintaining a healthy body weight may also help with prevention and management for plantar fasciitis.

Most cases of plantar fasciitis may improve with conservative treatment however, some cases may require surgery. If these symptoms bother you, seek your doctor to see if physical therapy is right for you.

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