Plantar Fasciitis - Everything You Need To Know

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.

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.

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.

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.

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.