R. Wendell Pierce M.D.
955 Main Street
Winchester, MA 01890
Phone: (781) 729-9577
Fax: (781) 721-0163
PLANTAR FASCIITIS
Also called “heel spur syndrome”, a common
problem in active people. Pain in the heel is
often worse in the morning, or after sitting
or standing for a while. The plantar fascia is a
a thick broad fibrous tissue that acts like a
bowstring to maintain the arch of the foot.
When it is overloaded or overstretched,
inflammation occurs, usually where it attaches
at the heel, resulting in pain. Eventually this
may result in a spike like projection from the
heel called a spur. The spur is not the cause
of the initial problem but rather a result of
the problem.
CONTRIBUTING FACTORS
Flat FeetHigh Arched Rigid Feet
Poor shoe supportRunning on toes, running hills
Soft terrain (sand)Sudden weight increase
Family tendencySudden activity increase
TREATMENT: May take several months or longer
Rest - Gradual return to activity and sports
Ice - Plastic bag of crushed ice to sore area 15 minutes after activity or twice per day.
Medications- Anti-inflammatories (NSAIDs) may be helpful in reducing pain and swelling. These medications have stomach and other side effects and should be used cautiously and usually not for prolonged periods.
Heel Pads, Cups or Orthoses (“Orthotics”) - Many varieties of off the shelf inserts, cups and pads are available. You may need to try several before finding one that helps. Occasionally a custom fit
insert is necessary
Shoes - Best shoe is a good running shoe with excellent support. The worst are usually loose fitting moccasins, loafers, slippers with
no shock absorption. Fortunately many companies such as Ecco, SAS,
Clark, Finn-Comfort, Mephisto and others are making excellent dress
shoes with good support and proper shock absorption. Occasionally
you may need a steel shank inserted in your shoe to add stiffness.
Physical Therapy - In some cases, hands-on physical therapy will
help reduce inflammation, stretch tight muscles and strengthen the
small muscles in the foot.
Night Splints - Occasionally in persistent or longstanding cases a
splint worn at night will help avoid contracture or tightening of the
calf muscle and Achilles tendon.
Injections - Some patients may require “cortisone” injections if
they have no relief from conservative measures
Surgery - Rarely needed, only after many months of treatment
using the above suggestions. Surgery consists of removing bone and
releasing the plantar fascia.
EXERCISES AND STRETCHES
Towel Curls - Use toes to curl towel toward you. May
May increase with weight on end of towel.
Shin Curls - Run foot up and down opposite shin
while trying to grasp shin with toes
Stretches - Achilles stretching is critical for
treatment and prevention. Stand
at arm length from table
front knee bent, back knee
locked, press gently forward
until feel moderate stretch
and hold 15 seconds. Then
bend back knee keeping heel
on floor and stretch again for
15 seconds. Change legs and
repeat. Should feel pull in
muscles but not pain.