Plantar Fasciitis Anatomy
Plantar fasciitis and the pain associated is one of the most common causes of foot and ankle pain.
The plantar fascia is the thick band of connective tissue running along the bottom of the foot that connects the heel bone to the toes. Plantar fasciitis is inflammation and pain where this connective tissue band attaches to the heel.
The plantar fascia absorbs shock when walking and aids in supporting the arch of the foot. Repeated stress and tension can create small tears in the plantar fascia and overtime, may cause irritation and inflammation known as plantar fasciitis. Due to repetitive stress and pulling of the plantar fascia, a heel spur may develop. When a bone spur is noticed during the treatment of plantar fasciitis, the underlying inflammation source is treated, as the inflammation is the source of pain experienced.
Commonly, plantar fasciitis is noticed as a stabbing pain in the foot or heel. It usually occurs during the first couple steps in the morning. Throughout the day the pain may decrease, but may also return after standing/walking for long periods or when beginning to stand after a longer period of sitting. This pain can become so bad as to limit activity.
Schedule an appointment today with Dr. Bryant Castelein, DPM – Podiatry Specialist
Conservative Treatment for Plantar Fasciitis
Conservative treatments help 90% of patients achieve desirable results.
Conservative care may consist of the following:
Custom inserts will reduce the tension placed on the plantar fascia and hold the foot in its neutral position to ensure the best mechanical pull of the tendons. When the foot is given the proper arch support, the plantar fascia is placed under less stress. This reduction of work placed on the plantar fascia allows recovery and reduces future damage.
Home Stretching Exercises:
Plantar fasciitis pain is aggravated by overly tight calf muscles. Dr. Castelein will prescribe specific stretches to complete at home to relieve and prevent the pain associated with plantar fasciitis. Stretching exercises are an essential aspect of treatment for plantar fasciitis.
In some cases, Dr. Castelein may suggest the use of formal physical therapy up to three times per week for a period of six weeks. During this time, a physical therapist will focus on stretching and strengthening the calf muscles. They will also incorporate other specialized methods to decrease swelling and inflammation in the plantar fascia.
Dr. Castelein may recommend the use of steroidal cortisone injections to reduce inflammation and pain. This medication is injected into the plantar fascia and is typically done in a series of three. Targeted steroidal cortisone injections allow for faster pain reduction while stretching and orthotics help provide lasting support and treatment.
Surgical Treatments for Plantar Fasciitis
In rare instances, plantar fasciitis pain may not respond to conservative treatment methods. Dr. Castelein offers minimally invasive surgery at multiple hospitals and outpatient surgery centers. Surgery to correct plantar fasciitis focuses on addressing the area of deformity based on the specific needs and anatomy of the patient.
Endoscopic Plantar Fasciotomy (EPF):
The EPF procedure aids in relieving chronic plantar fasciitis pain. It is a short outpatient surgery that involves a small incision on either side of the heel. A camera is then inserted into one of the incisions while a specialized tool is placed in the other. Dr. Castelein is able to fully visualize the plantar fascia and release the tight or contracted plantar fascia. This allows for the plantar fascia to heal in an elongated state. The day after surgery, patients typically report less symptoms than before the procedure was performed. During recovery, there is minimal time spent in the surgical boot. The EPF procedure has great results with 90% showing great improvement.
Endoscopic Gastrocnemius Recession (EGR):
This minimally invasive and highly effective surgical procedure aims to lengthen the tight calf muscles that contribute to the plantar fascia pain. Dr. Castelein creates a small incision near the back of the leg, below the calf muscle to allow a thin camera and instrument to be inserted. Dr. Castelein will use a small camera to view the tissue and locate the fascia of the gastrocnemius. Once here, Dr. Castelein will release a portion of the gastrocnemius, allowing the muscle to relax and lengthen. EGR is known as an outpatient procedure, allowing recovery in the comfort of your own home while wearing the surgical boot for four weeks.
Schedule An Appointment
& Exceptional Doctors