Plantar Fasciitis - Everything You Need To Know
What is Plantar Fasciitis?
Plantar fasciitis is one of the most common causes of heel pain and has been estimated to affect about two million people in the US, resulting in more than one million visits to both primary care physicians and foot specialists. Plantar fasciitis affects both sedentary and athletic people and is thought to result from chronic overload either from heredity, lifestyle or exercise. Current literature suggests that plantar fasciitis is more correctly termed fasciosis because it tends to be chronic rather than acute. Recent studies have posited the possibility of plantar fasciitis being chronically degenerative in nature rather than an inflammation. Treatment is often difficult because of the poorly understood mechanism by which the body heals chronic degeneration as opposed to acute inflammation.
The plantar fascia is fibrous tissue (neither tendon nor ligament) but rather is thought to be aponeurosis, a thin, sheet-like band connecting the heel to the metatarsals. Its main function is stabilizing and supporting the arch of the foot although it serves other functions related to gait. It can carry up to 14% of the total load of the foot depending on many factors such as ligament and tendon integrity. The plantar fascia is intrinsically connected to the Achilles tendon, especially in younger people which can explain why athletes with Plantar Fasciitis are more likely to present with Achilles Tendinitis and vice versa.
The plantar fascia is partially responsible for keeping the arch raised and springing the body forward during the propulsive phase of gait. Because of the hard surfaces that we walk on and the general population’s ever-increasing average weight, the Plantar Fascia is under more stress than ever to support our bodies. This combined with the fact that modern shoe construction has put more of an emphasis on style than form or function makes may account in part for the increase in plantar fasciitis cases.
What are the Symptoms of Plantar Fasciitis?
1. Pain in the heel area upon arising first thing in the morning or after prolonged sitting, which tends to subside after a few steps as the fascia stretches.
Much of the pain associated with plantar fasciitis is the result of the tension on the tissue being pulled between the calcaneus (heel bone) and the metatarsals (ball of the foot). Under weightbearing, the plantar fascia is pulled taut. Because the plantar fascia is connected in one place in the heel and 5 slips at the ball, the heel is the most likely place to feel pain. When not weightbearing, the plantar fascia contracts, pulling the heel and ball closer together. Then when weight is again applied to the foot after rest the plantar fascia once again is stretched tight, and the cycle is repeated.
2. Pain while walking up inclines or on uneven surfaces.
Because the plantar fascia is intrinsically related to the Achilles tendon, it is logical that when the Achilles is stretched, the plantar fascia is under tension. Walking up inclines, stretches the Achilles/PF complex, making the pull on the heel attachment worse.
3. Pain getting worse throughout the day, especially while standing for prolonged periods.
Sometimes patients report that standing causes the worse pain than walking as result of the constant pulling on the heel.
What are the Causes of Plantar Fasciitis?
Plantar Fasciitis can be caused by many issues, such as excess weight, over-pronation, walking or standing on hard surfaces and/or improper footwear and seems to target the middle age to older demographic. In some cases, having a higher-than-normal arch can place pressure on the Plantar Fascia attachment because of excess shock to the insertion of the ligament. Many times, sufferers of foot pain get caught up in a vicious pain cycle wherein because their feet hurt, they restrict their activities or do not exercise which causes weight gain which makes the foot pain worse.
What are the treatments or therapies for Plantar Fasciitis?
Physical therapy or using special devices might relieve symptoms.
- Physical therapy. A physical therapist can show you exercises to stretch the plantar fascia and Achilles tendon and to strengthen lower leg muscles. A therapist might also teach you to apply athletic taping to support the bottom of your foot.
- Night splints. Your physical therapist or health care provider might recommend that you wear a splint that holds the plantar fascia and Achilles tendon in a lengthened position overnight to promote stretching while you sleep.
- Orthotics. Your health care provider might suggest off-the-shelf or custom-fitted arch supports (orthotics) to distribute the pressure on your feet more evenly and cushion the foot. Many health care providers prefer carbon fiber inserts to conventional inserts. Carbon fiber insoles provide superior cushioning, support and stability. VKTRY Performance Insoles have been proven to reduce the joint loads on the lower extremities thereby supporting the plantar fascia and reducing ground reactive forces.
- Walking boot, canes or crutches. Your health care provider might recommend one of these for a brief period either to keep you from moving your foot or to keep you from placing your full weight on your foot.
- Injections. Injecting steroid medication into the tender area can provide temporary pain relief. Multiple shots aren't recommended because they can weaken your plantar fascia and possibly cause it to rupture. Platelet-rich plasma obtained from your own blood can be injected into the tender area to promote tissue healing.
- Extracorporeal Shock Wave Therapy. Sound waves are directed at the area of heel pain to stimulate healing. This is for chronic plantar fasciitis that hasn't responded to more-conservative treatments. Some studies show promising results, though this therapy hasn't been shown to be consistently effective.
- Surgery. Considered a “last resort” few people need surgery to detach the fibers of the plantar fascia from the heel bone. It is generally an option only when the pain is severe and other treatments have failed. It can be done as an open procedure or through a small incision with local anesthesia.
Can I Prevent Plantar Fasciitis?
- Maintain a healthy weight. Extra weight can put extra stress on your plantar fascia causing it to become tight and pull on the heel bone attachment.
- Choose supportive shoes. Buy shoes with a low to moderate heel, thicker soles, good arch support and extra cushioning. Try not to walk barefoot especially on hard surfaces.
- Don't wear worn-out athletic shoes. Replace your old athletic shoes before they stop supporting and cushioning your feet. The average life span on a good pair of running shoes is 500 miles. If you run 10 miles a week, consider replacing your shoes after about a year.
- Change your sport. Although this is really an impractical piece of advice, changing your activities may help in the treatment of plantar fasciitis. Try a low-impact sport, such as swimming or bicycling, instead of walking or running.
- Apply ice. Hold a cloth-covered ice pack over the area of pain for 15 minutes three or four times a day to help reduce pain and inflammation. Or try rolling a frozen bottle of water under your foot for an ice massage.
- Stretch your arches. Simple home exercises can stretch your plantar fascia, Achilles tendon and calf muscles. This includes rolling out the arch with a ball or cylinder shaped device as seen in the picture.
- Rest the feet- As simple as it sounds, in many cases, resting the affected foot can aid in the healing process and break the pain cycle.
Because the pain associated with plantar fasciitis is largely due to strain, one of the best ways to help relieve it is to allow the feet to rest from the activities that are causing it, and to “avoid running, walking or jumping on hard surfaces while healing.
Does Plantar Fasciitis Ever Go Away?
Plantar fasciitis can go away on its own, but it can take more than a year for the pain to subside. Without treatment, complications can occur such as heel spurs or even worse, tearing of the plantar fascia can result which can require surgery. It's better to see your health care provider and start non-surgical treatments right away.
Does Footwear Cause Plantar Fasciitis?
Even well-fitting shoes can hurt your feet if you aren’t wearing the right shoe for whatever activity or sport you are participating. Always wear the appropriate footwear with your intended activity. Playing soccer? Wear soccer shoes. Playing golf? Wear golf shoes. Running on a trail? Wear shoes designed for the activity. Always tend toward better quality footwear. Higher quality footwear has more support and cushioning than cheaper quality shoes. If you want to save money you may be better off saving it on clothes. As the old saying goes, a cheap shirt never hurt anybody, but cheap shoes have.
While the field research was impressive, VKTRY hired The Korey Stringer Institute at the University of Connecticut to study the product in a clinical study. The summary of the independent clinical research is stated by Dr Douglas Casa, PhD and CEO of KSI:
“After an extensive 6-month research study, it is clear that VKTRY Insoles improve lower body biomechanics, stability of the ankle and knee during running, and shock absorption during landing. These improvements can help safeguard athletes by providing injury protection.”
Carbon Fiber Plate Technology for Protection and Recovery from Plantar Fasciitis
With advances in material technology, carbon fiber insoles have come to the forefront for the protection and recover from Plantar Fasciitis. At the forefront of carbon fiber insole technology is VKTRY Performance Insoles (VKs). VKs stabilize the midfoot and support the longitudinal arch by providing a stable base and limiting pronation, two of the main causes of plantar fasciitis.
During the gait cycle, VKs absorb shock at heel strike by resisting the ground and deflecting, slowing the rate of deceleration and attenuating shock in the sagittal plane, much like landing on a springboard and slowing the user down efficiently.
In the second phase of gait, midstance, VKs absorb shock and provide a pre-load, assisting the Plantar Fascia in storing energy preparing for stage three.
During the third stage of gait, heel off, VKs store the energy generated during heel strike and midstance at the metatarsals in preparation for the propulsive stage.
During stage four, VKs release the potential energy stored in the first three stages directly into the ground, greatly increasing the amount and rate of plantarflexion.
For foot structures that lack efficient energy storage, in the case of flat feet or high arches or have excessive pronation, VKs add the spring for feet with this deficiency.
One of the other functions of the plantar fascia is to propel the body forward by using the spring mechanism resulting from the loading (elongation and deflection) to store energy at midstance and heel off, and release it during contraction at plantarflexion.
VKs mimic and thereby assist the function of the plantar fascia supporting the arch, limiting pronation to maximize the plantarflexion moment, improving foot function in any direction for improved gait efficiency in any sport or activity.
Are Carbon Fiber Insoles Uncomfortable?
Some of the very rigid, full-length carbon fiber plates used to immobilize a foot can be uncomfortable (some people have referred to them a “medieval”). However, VKTRY Insoles are made from multiple layers of carbon fiber which allows them to easily flex. Some individuals may feel pressure at the ball of the foot during the break-in process, but this is totally normal. Start by wearing your insoles for a short time at first, maybe 30 minutes, and then gradually increase the time as you get used to the new pressures on the bottom of your foot. Most people find VKs very comfortable after the 3-5 day period.
10.) How Long Do Carbon Fiber Insoles Last?
This can vary from 6 months to 6 years and really depends on how well the user cares for the product. Carbon fiber insoles are rated for hundreds of thousands of cycles (flexes), however factors such as moisture, dirt, abrasives and shoe type can affect the life of the carbon fiber. On one hand, the lifetime of the product can be reduced for cleated sports, where dirt and gravel may come in contact with the insole, resulting in abrasion. On the other hand, if the athlete is using the product for a straight-ahead sport like distance running, the life of the insoles would be extended, and the foam top cover would likely wear out before the carbon fiber baseplate. To extend the life of the product, manufacturers recommend inspecting and cleaning the product every few weeks. If the carbon fiber shows any signs of cracking, it’s time for a new pair.
VKTRY Insoles have been successful in helping athletes with injuries, as evidenced by field research, clinical studies and in thousands of customer testimonials. However, when it comes to health care, all people and all injuries are not alike. VKTRY always recommends that you consult your physician when considering treatments of an injury. And VKTRY offers a 90-day money back guarantee, so if the product is not helping a person in recovery, VKTRY provides a no questions asked refund. For more information, please click the button below.