Plantar fasciitis made the headlines this week when Eli Manning, Quarterback for the Giants needed to leave the game due to sharp heel pain from an inflamed plantar fascia. Plantar fasciitis is a painful condition that affects nearly 15 percent of the population. The plantar fascia is a thick, strong ligament located on the bottom of your foot and helps to hold up your arch. It stretches from your heel to the ball of your foot. Plantar fasciitis occurs when the ligament becomes aggravated. Conditions that may damage the plantar fascia include: flat feet, high arches, heavy weight lifting, standing on hard surfaces for long periods of time and improper shoes. When the plantar fascia is stressed over a long period of time, the heel bone reacts to protect itself and forms a spur.
The symptoms of plantar fasciitis and heel spur syndrome (when a spur is also present) are usually worse when you first get up in the morning, or when you first stand up after resting. Increased activity, and long periods of standing often make the next day miserable. The heel feels swollen and may cause you to limp. The pain is usually located right in the middle of the heel or just to the inside. These are classic symptoms and are the easiest to treat with proper shoes, ice, anti-inflamamtory drugs like Ibuprofen, and not going barefooted.
The diagnosis is usually made with a thorough exam. X-rays are often used to rule out fractures and spurs. Eli Manning had an MRI to rule out a more serious injury like a stress fracture that may have gone undetected on a standard X-ray. An MRI is usually required only when there is an unexpected amount of pain or if some other problem needs to be ruled out like a stress fracture or tumor. Diagnostic ultrasound is a cost effective, pain free, and very accurate screening tool that is performed in the office when there is a difficult case that requires additional testing to make an accurate diagnosis.
If symptoms don’t improve over a few weeks, if there is evidence of infection or there is a recent history of trauma we recommend that you seek professional advice ASAP. For patients that have recurrent problems or have intense symptoms, combination treatment may be in order. Things like custom arch supports (orthotics), physical therapy, stretching exercises; NSAIDs (nonsteroidal anti-inflammatory drugs like aspirin, Aleve and Motrin), night splints, cortisone injections, and even surgery all have a place in treating some types of heel pain.
Newer non invasive or minimally invasive treatments like ESWT (shock wave therapy), blood patch or prp injections (a growth factor injection using your own platelets), EPF (endoscopic plantar fascia release), and neurolysis can help reduce and eliminate symptoms. If you are suffering from heel pain we recommend that you contact one of our board certified physicians at 262 821-1588 or visit us on the web at: www.allcarefootandankle.com
About the author:
Dr Waldman is a board certified Podiatrist
Fellow of The American Board of Foot and Ankle Surgeons
Medical Director of The Allcare Foot and Ankle Group
Allcare Offices: New Berlin, Oak Creek, Fox Point, and Wauwatosa
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