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Plantar Fasciitis
Dr Kau Chung Yuan (许医生)
MBBS (S’PORE)
MRCS (Ireland)
MMed (Ortho)
FRCSEd (Ortho)
What is Plantar Fasciitis?
Plantar Fasciitis is a common condition affecting the foot, specifically the plantar fascia, a thick band of tissue that runs along the bottom of the foot and connects the heel bone to the toes. This condition typically causes pain in the heel area, which can be particularly pronounced after periods of rest or in the morning.
Causes
The development of plantar fasciitis is often associated with various factors that can contribute to stress on the plantar fascia. These factors include:
- Excessive Weight and Pressure
Being overweight or obese can put extra stress on the plantar fascia. - Foot Mechanics
Foot mechanics, such as flat feet, high arches, or abnormal walking patterns, can affect how weight is distributed when standing, adding stress to the plantar fascia. - Age
Plantar fasciitis is more common in adults aged 40 to 60. - Certain Types of Exercise
Activities that place a lot of stress on the heel and attached tissue, such as long-distance running, ballet dancing, and aerobic dance, can contribute to the onset of plantar fasciitis. - Occupational Factors
Jobs that require long hours on your feet can contribute to the development of plantar fasciitis..
Symptoms
The symptoms of plantar fasciitis are distinct and typically concentrated around the heel area of the foot. Key symptoms include:
- Pain in the Heel
The most common symptom is a sharp, stabbing pain in the bottom of the foot near the heel. This pain is often worse with the first few steps in the morning or after sitting for an extended period. - Pain After Exercise
Pain may not manifest during physical activity but can develop shortly afterwards. - Stiffness and Tenderness
The bottom of the foot may feel stiff or tender when touched or when pressure is applied to it.
Diagnosis
Diagnosing plantar fasciitis typically involves a thorough examination of the foot by an orthopaedic surgeon. The process may include:
- Medical History Review
The orthopaedic surgeon will discuss symptoms, physical activities, and past foot issues. - Physical Examination
The foot is examined for tenderness, stiffness, and signs of inflammation. The orthopaedic surgeon may also assess the foot and leg’s strength, alignment, and reflexes. - Imaging Tests
Though not always required, imaging tests such as X-rays or MRIs may be recommended to rule out other conditions like bone fractures or to assess the extent of tissue damage.
Non-Surgical Treatment Options
Most people with plantar fasciitis can relieve their heel pain with non-surgical treatments. These include:
Rest and Ice
It is crucial to reduce or stop activities that make the pain worse. Applying ice to the heel for 15-20 minutes, three or four times daily, can reduce inflammation and pain.
Stretching Exercises
Stretching the Achilles tendon and plantar fascia can help alleviate pain and improve flexibility.
Orthotics
Custom-fitted arch supports (orthotics) can distribute pressure more evenly across your foot.
Anti-inflammatory Medications
Nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen or naproxen, can reduce pain and inflammation.
Physical Therapy
A physical therapist can show exercises to strengthen the lower leg muscles and stabilise the ankle and heel.
Night Splints
Wearing a splint at night can stretch the calf, and the foot arch, and holding the plantar fascia and Achilles tendon in a lengthened position overnight can promote stretching.
Surgical Treatment Options
In cases where plantar fasciitis does not respond to non-surgical treatments and symptoms persist for 6-12 months, surgical options may be considered. These include:
- Plantar Fascia Release
This involves partially cutting the plantar fascia to release tension and reduce inflammation. It can be performed as an open procedure or through a minimally invasive method known as endoscopic plantar fasciotomy. - Gastrocnemius Recession
If tight calf muscles contribute to the problem, this procedure involves lengthening the calf muscles to increase ankle motion and decrease stress on the plantar fascia.
Dr. Kau Chung Yuan
MBBS (S’pore)
MRCS (Ireland)
MMed (Ortho)
FRCSEd (Ortho)
Dr Kau (许医生) is a Fellowship trained Orthopaedic Surgeon with a subspecialty interest in Hip and Knee surgery and has been in practice for more than 15 years.
He is experienced in trauma and fracture management, sports injuries, and joint replacement surgery.
- Fellow of the Royal College of Surgeons Edinburgh, Orthopaedics (FRCS, Edin) 2014
- Master of Medicine (Orthopaedics), Singapore (MMed) 2013
- Member of the Royal College of Surgeons Ireland (MRCS, Ire) 2009
- Bachelor of Medicine and Surgery (MBBS, Singapore) 2004
Preventive Strategies
Preventing plantar fasciitis involves measures to reduce strain and stress on the plantar fascia. Key prevention strategies include:
- Maintain a Healthy Weight: Keeping a healthy weight minimises the stress on the plantar fascia.
- Choose Supportive Shoes: Wear shoes with good arch support and a cushioned sole.
- Stretch Regularly: Regular Achilles tendon and plantar fascia stretching can increase flexibility.
- Do Not Overdo Activities: Gradually increase the intensity and duration of any new exercise routines.
- Use Orthotics as Needed: Custom orthotics or arch supports can help evenly distribute pressure to your feet.
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Singapore 217562
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Frequently Asked Questions (FAQs)
Can Plantar Fasciitis Go Away on Its Own?
Plantar fasciitis often improves with time as the inflamed tissue heals. Key to this natural recovery is rest, avoiding activities that worsen pain, and implementing simple home treatments. While many cases improve within several months, recovery time varies based on the severity of the condition and adherence to recommended care.
Is Walking Good for Plantar Fasciitis?
Walking, when done correctly, can aid in the recovery from plantar fasciitis. Walking in a way that does not aggravate the condition is important. This means choosing well-cushioned and supportive footwear, avoiding walking on hard or uneven surfaces, and limiting distances to avoid overstraining the plantar fascia.
Gradually increasing walking distances can help the foot adapt and recover, but if pain increases, it is important to reduce activity and consult an orthopaedic surgeon.
How Long Does It Typically Take to Recover from Plantar Fasciitis?
The recovery time from plantar fasciitis varies widely among individuals. Generally, many people start to see improvement within weeks to a few months. However, complete recovery can take up to a year, especially in more severe cases. Consistency in following a treatment plan is key to reducing recovery time.
Are There Any Long-term Complications Associated with Plantar Fasciitis?
Unchecked, plantar fasciitis can lead to chronic heel pain that hinders daily activities. Persistent pain may cause a change in your walking pattern, potentially leading to foot, knee, hip, or back problems.
Chronic plantar fasciitis can also lead to heel spurs, growths of bone on the heel caused by the continuous pull of the plantar fascia. Addressing the condition early is important to prevent these long-term complications.