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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.

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Plantar Fasciitis Anatomy

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Conservative Treatment for Plantar Fasciitis

Conservative treatments help 90% of patients achieve desirable results.

Conservative care may consist of the following:

Custom Orthotics:

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.

Physical Therapy:

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.

Cortisone Injections:

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.

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Client Testimonials

Julie
I'm so happy to have found Brighton Foot And Ankle in Brighton. The office staff and assistant are very pleasant. Dr. Bryant Castelein is a great knowledgeable Dr. Who has eased my worry over my medical condition. Plus he's handsome. I would highly recommend this practice for anyone needing podiatry help.
Amy
What great people to help you! From receptionist to doctor, they are top notch! You would not regret going here for any of your foot/ankle problems, they will fix you up with the utmost care and compassion.
Yo K
Dr. Castelein and staff were friendly, knowledgeable , efficient and took the time to get to know me and understand my medical needs. I would not hesitate to go to Brighton Foot & Ankle. They go out of their way to treat their patients like family.
Robert
Dr. Castelein is great; he is very nice, patient, and professional. His staff is also excellent and friendly. It's only been about three hours since having my big toenail removed and, with acetaminophen and ibuprofen, there is very little pain(sometimes I completely forget about it); he did an excellent job. Overall, I am very impressed with Dr. Casteleins Practice and I would highly recommend his office.
Joseph
Doctor & staff were so professional, friendly & efficient. I had a high risk condition that they expertly guided me through 5 months of healing. Thankfully a full recovery. I give them my best recommendation.
Lexi
Very friendly and accommodating front desk staff. Dr. Castelein and Jennifer always take their time and do an amazing job! Great variety of quick pick up over the counter products that are always affordable too. Best experience I have had at an office.
Christena
Dr. Castelein is very friendly and extremely knowledgeable in his field. During my visit he did a great job explaining my situation and was very encouraging of any questions. I never felt rushed and I believe to have received the best care possible. Highly recommend this doctor and this facility.
Nicole C
Excellent staff and exceptional doctor. I went in with Bunion issues. Dr. Castelein listened to my concerns and addressed my options. 4 days post-op bunion surgery I can say he did an amazing job. Best experience I have ever had. I would definitely recommend; I promise you won't look further.
Ashley
The staff and Dr. Castelein are all amazing. They are polite and very respectful. I came to see them in 2019 for bunion and hammer toe issues among some others. Dr. Castelein and his assistant listened to my concerns and gave me my options. He explained everything to me in detail and all my questions were answered.. I have seen other podiatrists and he is beyond the best. I would recommend him to anyone.
Alex
Friendly staff and intelligent doctor! I went in for some ankle X-rays and was given a great strategy on the different ways to heal my ankle, and how to progress forward if less invasive treatment doesn't help. I would highly recommend them to anyone with foot or ankle problems!