Most of you have heard of this condition and probably know someone who has had Plantar Fasciitis. What is this dastardly process? Plantar refers to the bottom of the foot and fascia refers to a strap that connects things together; therefore, the plantar fascia is a strap on the underside of the foot that ties the heel to the toes. It helps to provide support for muscles in the foot and also acts as one of the means whereby the arch is held in a curved position. (Much like a bowstring connects the ends of a bow and helps it to stay curved!)
Sometimes that fascia strap can get frayed where it attaches to the heel bone – and that causes pain.
What causes plantar fasciitis? We know that both women and men get this problem with women being affected more often than men (Not fair – I agree)! It rarely occurs in younger people and is more common after age 40. Those who are overweight, flat footed, have tight heel cords (Achilles tendons), those who wear high heeled shoes, and those who run are at potential risk for this problem.
What symptoms are associated with plantar fasciitis? The typical symptom is usually pain on the bottom of the heel when one gets out of bed and starts to walk. Likewise, sitting for a while and then getting up to walk is oftentimes painful. Exercise can also bring on this nasty bugger. Many folks don’t recall any new or traumatic events that preceded the arrival of the pain – a rather disgusting state of affairs.
How is plantar fasciitis diagnosed? Usually your doctor can arrive at a diagnosis based simply upon your physical exam in the clinic. Oftentimes, X-rays are obtained to rule out other causes. As a side note, many people with the diagnosis of Plantar Fasciitis will have a “heel spur” on their X-rays. Many years ago it was presumed that the spur was the cause of the problem, but we consider it a result of the problem – so even though it looks “guilty” on an X-ray it isn’t the culprit. Below is a picture of a heel spur.
How do I treat my Plantar Fasciitis? The initial course of treatment is conservative; ice, heel cups, NSAIDS (Aleve), physical therapy, night splints (which are worn to bed and keep the toes and foot from pointing downward during sleep) as well as arch supports are used. Other times, the pain and disability are so bad that a “CAM” boot (one of those just below the knee black clunky splints) are helpful. The process will commonly resolve on its own after several months – but if it hurts, few want to wait that long. In more extreme cases, a steroid shot or one of the newer medications, such as platelet enriched plasma or MVasc, can be injected into the tender site of the foot. In those people who fail all conservative treatments there are surgeries that can ultimately resolve the problem. One of the newest of these surgeries is called the “TENEX” procedure. It is an outpatient procedure done thru a small incision along the heel and, in skilled hands, has a very high cure rate. Dr. David Huebner, Foot and Ankle specialist at New West Sports Medicine, treats plantar fascia problems and is fully trained in the Tenex surgery.
If you think you might have this problem please call New West Sports Medicine (308-865-2570) and one of our Foot and Ankle trained orthopedic surgeons will be happy to see you and get you “back on your feet”! As always, no referral is necessary and same day appointments are available.