Plantar Fasciitis is an inflammatory process that occurs in the plantar fascia, usually at the insertion to the heel bone (calcaneus). It has been reported that 10% of the worldwide population will suffer from this condition at some point in their lives. The inflammatory process is thought to occur due to repeated trauma to the plantar fascia as it is over-stretched. In other words, the burden on the foot is too great for the plantar fascia to maintain the foot arch and therefore the arch 'collapses' or 'falls' slightly more than it should, thus over-stretching the fascia. This causes damage (micro-tears) in the plantar fascia which triggers the inflammatory response, causing pain. In the vast majority of cases this process occurs at the origin of the plantar fascia at the heel bone.
Arch pain can be caused by several different factors. Tight calf muscles combined with repeated arch collapse on weight bearing, is the most common cause of arch pain.This can then often lead to a condition called plantar fasciitis, which is an inflammation of the connective tissue that connects the heel with the ball of the foot. When the connective tissue in the bottom of the feet gets stretched out too much, plantar fasciitis can result. The inflammation resulting from plantar fasciitis can result in arch pain. Arch pain caused by plantar fasciitis is often worst after long periods of rest, like when you first wake up in the morning. This is because the plantar fascia tightens when you are off your feet. When you wake up in the morning and start walking around, the plantar fascia stretches out again.
Arch pain symptoms could include any of the following, a dull, constant ache if the ligaments have been stretched, swelling or tenderness in the foot, redness or bruising in the event of a more serious injury, difficulty putting weight on the foot, sharp pain when the foot is turned or manipulated, tenderness when pressure is applied. Because the arch of the foot is such a complex structure, arch pain could be an indicator of several different types of injuries. Chronic illnesses such as arthritis could also cause arch pain, and depending on the cause or source of your pain, you may experience discomfort in a variety of different areas. Ask a doctor if you believe you may have injured your foot arch.
A patient is asked to step with full body weight on the symptomatic foot, keeping the unaffected foot off the ground. The patient is then instructed to "raise up on the tip toes" of the affected foot. If the posterior tibial tendon has been attenuated or ruptured, the patient will be unable to lift the heel off the floor and rise onto the toes. In less severe cases, the patient will be able to rise on the toes, but the heel will not be noted to invert as it normally does when we rise onto the toes. X-rays can be helpful but are not diagnostic of the adult acquired flatfoot. Both feet, the symptomatic and asymptomatic - will demonstrate a flatfoot deformity on x-ray. Careful observation may show a greater severity of deformity on the affected side.
Non Surgical Treatment
Just as there are many different causes of flat feet, there are also many different treatment options. The most important aspect of treatment is determining the exact type or underlying cause of flat feet that you have. Foot and ankle specialists can determine this through thorough clinical examination and special imaging studies (e.g., x-rays, computed tomography, and/or magnetic resonance imaging). Conservative treatment is effective in the vast majority of flat foot cases, and consists of things such as insoles, splints, manipulation, or casting. Surgery is required much less frequently, and is reserved only for some of the severe types of flat foot that do not respond to conservative therapy.
In rare cases, surgery may be needed if a child has flat feet caused by a problem they're born with (a congenital abnormality). The foot may need to be straightened or the bones may need to be separated if they're fused together. Painkillers and insoles are the first treatment options for flat feet that are caused by a joint problem, such as arthritis or a torn tendon. However, surgery may be recommended if the injury or condition is severely affecting your feet. Where flat feet are caused by a condition that affects the nervous system, special shoes, insoles, or supportive foot or leg braces may be needed. Again, in severe cases, an operation may be needed to straighten the feet.
Below are two simple plantar fasciitis stretching exercises to help improve the flexibility of the muscles and tendons around the foot and ankle. Plantar fasciitis stretch taken from The Stretching Handbook. Kneel on one foot and place your body weight over your knee. Keep your heel on the ground and lean forward. In the photo to the left, the athlete is stretching the arch of her left foot. Kneel on one foot with your hands on the ground. Place your body weight over your knee and slowly move your knee forward. Keep your toes on the ground and arch your foot. In the photo to the right, the athlete is stretching the arch of his right foot.