Do you often experience heel pain? Especially after waking up in the morning or after a long day at work? Do you spend a lot of time standing and walking at work? There's a high probability you're dealing with plantar fasciitis, a condition many also know as "heel spurs". Hearing such terms probably raises many questions: what is it, why does it occur, and what should be done? Let's figure it out together!
To understand what plantar fasciitis is, it's important to know where the plantar fascia is located and what its purpose is. Let's start from the beginning: the fascia is a thick, fibrous (connective tissue) ligament. In the foot, it attaches to the medial tubercle of the calcaneus (heel bone) and extends to the toe bones. The plantar fascia is essential for maintaining the arch of the foot and distributing weight when walking or running.
WHY DOES HEEL PAIN OCCUR?
Excessive load on the plantar fascia causes micro-injuries. It was long believed that this led to inflammation of the fascia, but recent studies indicate that this pathology involves numerous small tears in the fascia, which heal improperly and cause pain.
DO I BELONG TO A RISK GROUP?
This pathology most commonly affects middle-aged, overweight individuals, especially those who walk or stand a lot daily, have flat feet, and it is more prevalent among women. Risk factors for plantar fasciitis also include wearing inappropriate footwear, such as shoes with very flat, hard soles that lack proper arch support. Unfortunately, wearing high heels is also associated with plantar fasciitis. But there's no need to panic! As many as 10% of the population encounter this pathology and successfully treat it, returning to their normal lives.
HOW DO HIGH HEELS AFFECT THE PLANTAR FASCIA?
When walking in high heels, the weight in the foot is distributed unevenly, and the arch of the foot receives a greater load. Additionally, the posterior calf muscles, which attach to the heel bone via the Achilles tendon, are constantly tense. Since these muscles receive a greater load, there is a risk of the Achilles tendon shortening, and as it shortens, the plantar fascia is stretched more and thus damaged.
WHAT ARE "HEEL SPURS"?
"Heel spurs" are not the same as plantar fasciitis, but they often occur with this condition. Due to constantly traumatized fascia, a bone spur can form at its attachment point to the heel bone, which is called a "heel spur." It also causes discomfort and pain.
HOW IS PLANTAR FASCIITIS DIAGNOSED?
Specific tests are usually not needed to diagnose this pathology. We diagnose based on typical symptoms and during clinical examination.
In certain cases, a magnetic resonance imaging (MRI) scan may be used, which can show a thickened fascia and small tears. However, this is performed very rarely. To assess whether bone spurs, the aforementioned "heel spurs," have formed, foot X-rays are taken.
HOW IS PLANTAR FASCIITIS TREATED?
Treatment always begins with conservative methods. Rehabilitation and kinesiotherapy procedures are very beneficial. After assessing the patient's functional condition, the kinesiotherapist prescribes appropriate exercises, most often various stretching, rolling, and strengthening exercises for the ankle, foot, and calf muscles. It is very important to continue these exercises independently even after completing rehabilitation treatment.
As I mentioned, footwear also has a significant impact on this condition. Therefore, it is important to choose appropriate shoes; ring-shaped inserts can be used in footwear to distribute the load and reduce it in the heel area.
If conservative treatment is ineffective, cortisone (steroidal hormone) injections into the plantar fascia may be administered to reduce pain.
HOW TO HELP YOURSELF AVOID PLANTAR FASCIITIS?
1. Choose comfortable shoes that are adapted to your foot and suitable for your foot arch.
2. After wearing high heels, it is important to perform stretching exercises for the foot and posterior calf muscle group.
3. And most importantly, seek a specialist in time! If you notice that the mentioned complaints are bothering you more and more often, do not wait and consult an orthopaedic traumatologist!
Do you have questions? Write to me, and we will try to find the most suitable solution for your problems together!
Karolina
