PLANTAR FASCIITIS

The plantar fascia is a thick fibrous tissue that extends from the heel to the forefoot. It is responsible for supporting the joints, bones, and muscles of the soles when walking. Plantar fasciitis means inflammation of the plantar fascia. The longer the inflammation lasts, the greater the chance of causing calcaneal bone spurs. However, calcaneal bone spur itself may not have any symptoms.

There are many causes of inflammation, for example,  overuse,  overweight, prolonged standing, too much walking, too high jogging mileage, or structural defects, etc. Flat feet, high foot arch, shorten Achilles tendon can also cause abnormal tension on the plantar fascia.

Studies have shown that plantar fasciitis may be triggered by training errors, such as a sudden increase in mileage or training frequency, or vigorous upslope training. Too hard or too soft ground surface (concrete, grass, sand, etc.), insufficient recovery time, and running on an uneven surface lead to the painful condition as well. Improper choice of running shoe (too soft, too tight, too hard insole, insufficient arch support, lack of shock absorption, etc.) also strain the plantar fascia. Because the plantar fascia connects to calf muscle insertion, tight calf muscles pull to increase fascia tension excessively. It thickens and reduces the flexibility of the fascia.

• Significant heel pain, which may radiate to the arch of the inner foot
• Feel pain when first landing after wake up and even walk with difficulties
• Relieve pain in the early stages after warming up
• Standing or exercising too long will elicit the pain again

Do more calf and plantar fascia stretching to reduce pain. Patients should rest as much as possible and apply ice and electrical modalities to reduce pain and inflammation. Also, one can do soft tissue massage and release to painful areas. Applying transverse friction massage to the plantar fascia can reduce tension, improve blood circulation and promote recovery. Patients should choose soft and comfortable shoes, avoid high-heeled, too tight or too hard shoes. If the condition persists for few months, one can try shockwave or injection therapy.

Use non-stretchable sports taping or arch support pads to maintain the foot arch and reduce irritation. To resume training, you must have fewer miles than before, reduce the intensity, and the training surface should not be too hard. The "10% rule" is always a safe training guideline, which means that you cannot increase your mileage or intensity by more than 10% weekly to reduce the chance of relapse.

If you need to stand for a long time at work, you should try to take breaks as much as possible. People who are overweight must try weight management. Runners should not increase the training volume too quickly and should stop when the plantar fascia is still inflamed. One should choose suitable running shoes to protect their feet. Avoid excessive stimulation of the plantar fascia, which makes the inflammation worse.

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