Putting your best foot forward can help prevent plantar fasciitis

by Karen Bowen

When you first step out of your rig after a long drive, do you ever feel a stabbing pain in your heel?  If so, you may have plantar fasciitis.  

What causes plantar fasciitis? When your plantar fascia, the ligament on the bottom of your foot that connects your heel bone to your toes, is strained, it becomes weak, irritated and painful, and affects the collagen fibers connecting the ligament to the heel.  

Although plantar fasciitis usually affects just one foot, it can occur in both feet at the same time. Typically, the bottom of the foot is acutely painful when you take your first step in the morning. Even though the pain may subside as you continue walking on that foot, after sitting for a while and then walking again during the day, the pain is even more noticeable. Standing still for long periods can exacerbate the condition and the simple act of climbing stairs can be especially excruciating.  

The plantar fascia plays an important role in walking and jumping. Acting as a shock-absorbing bowstring, it supports the arch in your foot. Too much tension on the bowstring may cause small tears, leading to irritation and/or inflammation: plantar fasciitis.

A number of factors increase your risk of developing this condition. The first is age. Plantar fasciitis is more common in middle-aged people. However, younger people who spend a lot of time on their feet may also be affected: athletes, long-distance runners, ballerinas, and soldiers.

As well, women are more prone to plantar fasciitis, perhaps due to their fashionable shoe styles. Regularly wearing high heels can cause the Achilles tendon to contract and shorten, causing extra strain on the heel. However, men can be affected too. Any footwear that is loose or thin-soled, or does not have enough arch support or padding to cushion your step may contribute to developing this condition.

In addition, carrying excess weight puts extra strain on these foot ligaments, especially for ‘hard walkers’ whose step falls directly on the heel.

Also, certain occupations increase your risk. Jobs, like truck driving, that require sitting for long periods of time and then jumping or walking without the opportunity to first stretch or warm up your muscles can strain your foot ligaments. Other jobs that require workers to stand on hard, flat surfaces for extended periods of time, like factory workers and teachers, can damage your feet.

Tight calf muscles have also been directly linked to experiencing plantar fasciitis because this tightness causes a continual over-stretching of the plantar fascia, which leads to thickening and bruising of the ligament.

Heredity, too, may play a role. People who are flat-footed, who have high arches or excessive pronation (feet that naturally roll inward), often walk with an unusual gait to compensate and maintain their balance. These conditions affect the way body weight is distributed when the person stands or walks and put extra stress on foot ligaments.

The pain associated with plantar fasciitis is similar to many other foot-related conditions, so it’s important to see a doctor for a proper diagnosis.

To prepare for your appointment, make a list of the types of physical activities you participate in and when your foot hurts the most.

During the examination, your doctor will probably note your reflexes, muscle strength, muscle coordination and balance while walking. A foot

X-ray may be ordered to rule out a stress fracture, bone spur, or other bone-related conditions.

Once plantar fasciitis has been diagnosed, your treatment plan may include some of the following recommendations:

Rest your foot frequently during the day to allow the fascia ligaments to regenerate.

Take painkillers (ibuprofen, Advil or naproxen) or apply ice to manage pain.

Stretch your ligaments, which will be painful, to help your foot regain strength.

Upgrade your footwear to include shoes with good cushioning and arch support to maintain appropriate foot alignment and prevent further injury.

Wear night splints to stretch the ligaments to prevent contraction of the ligaments during this extended period of inactivity.

Wear a heel cup, cushioned shoe inserts, or felt pad in the heel area for extra shock-absorbency. Use custom orthotics, if necessary.

In severe cases, steroid shots into the heel or foot surgery may be needed.

Although the above non-surgical treatments almost always reduce the pain, several months of treatment may be required before your notice an improvement. Even though most people feel better within nine months, some still need surgery.

To avoid plantar fasciitis altogether, here are a few tips.

Make sure your ankle, Achilles tendon, and calf muscles maintain their flexibility through regular movement.

Maintain a healthy weight to avoid stressing the ligament.

Feed your connective tissue with a well-balanced diet. Keep your ligaments well-hydrated by drinking enough water.

Always try to put your best foot forward by taking the above steps.

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