Achilles Tendon Pain

Posts Tagged ‘Plantar’

Plantar fasciitis occurs when the plantar fascia is extended as a result of increased or over activity, inadequate foot biomechanics or in association with the usual aging process.  The aim of the plantar fascia is to act as a shock absorber and support the arch of the foot.  The plantar fascia is normally overstretched time and again before any pain is felt.  The pain results from recurring microscopic tears occurring in the plantar fascia, usually where it attaches to the heel bone.  

This leads to inflammation, pain in the heel, and possible visible bruising where the plantar fascia joins the heel.  The pain is normally felt at the bottom of the heel, often on the interior of the heel, however may also occur in the arch of the foot itself or further forwards nearer the toes of the foot.

Stretching plays an important part in recovery from plantar fasciitis.  Performing routine, daily flexibility exercises on the base of the foot, back of the foot and calf muscles, typically lessens the amount of tension in the damaged plantar fascia and encourages the healing process.  It is very common to find plantar fasciitis patients with diminished ankle movement range and very tight Achilles tendons.  Loosening up these areas slims the probability of suffering from plantar fasciitis again.

In recent tests more than eighty percent of those suffering from the condition reported that increasing flexibilit assisted their recuperation and over 25% thought that their flexibility regimes were the most helpful treatment they used.

Regular gentle stretching is the key.  Patients should be sure to start their stretching very slowly and carefully at the start of your treatment because going too far at first during the first points of treatment and recovery can easily re-injure the plantar fascia and aggravate the condition.  Slow and steady is the best approach to stretching and best results are brought about by a ‘little and frequent’ approach.  Patients should stretch at least two times daily (preferably more) instead of diving into one long, over enthusiastic stretching session on once in a while basis.

Because of the risk of re-injury resulting from over-enthusiastic stretching, you must follow a planned stretching program that has been planned to increase effort slowly as the plantar fascia rebuilds.  

Catching plantar fasciitis early and a detailed plan of treatment are important for healing plantar fasciitis.  If treatment is delayed or deficient in the initial stages of the condition, plantar fasciitis can take nearly eighteen months or more to be fully treated.  However by adhering to a suitably structured treatment schedule and fusing some of the individual treatments available, thankfully in the majority of reported cases, non-surgical treatment leads to a complete cure.  Only in the most extreme of cases is surgery needed.

It can take several months for symptoms to go away and the plantar fascia to be fully healed.  Remember that a torn ligament (even only very tiny tears) only happens after repeated and extended stress and to reverse this, prolonged treatment will be required.  Also, the longer the patient has been suffering from plantar fasciitis and the worse the heel pain, the longer the treatment will take.

About 1 in 10 people will suffer from plantar fasciitis at any point in their lifetime, making this a very common condition. The main symptom of plantar fasciitis is pain, commonly felt about 4 cm (1,5 inch) forward from the heel.  Plantar fasciitis means inflammation of the plantar fascia, which is a strong band of fibrous tissue that stretches from the heel to the middle foot bones.

The pain usually eases on resting of the foot, but is often at its worst first thing in the morning or after long periods where no weight is placed on the foot. Gentle exercise may ease the pain a little, but a long walk will aggravate the pain.

People especially at risk getting plantar fasciitis are the ones that do a lot of walking, running, standing, etc.  In addition, people who have recently started exercising on a different surface, like running on the road instead of a track, also have a greater risk of the condition. Some people find that a poor arch support, or a sudden increase in weight can bring on the symptoms.

Often though, there is no apparent cause, especially in older people. A common wrong belief is that the pain is due to a bony growth or ‘spur’ coming from the heel bone (calcaneum). Many people have a bony spur of the heel bone but not everyone gets plantar fasciitis.

There is no specific treatment that appears to stand out as the best. A combination of different treatments does help though. The treatment plan for people suffering from plantar fasciitis can be as follow:

Rest the foot
By scannning the soles of your feet, one can see of one of the three arches in the foot has dropped, which might contribute to the pain. If so, custom made orthotics might help. They speed up recovery remarkably by supporting all of the three arches of the foot, thereby decreasing the tension on the plantar fascia and thus quickening the healing process.
Cross friction techniques can be used to stimulate blood supply to the plantar fascia to promote tissue heeling.
Gentle stretching exercises of the Achilles tendon and plantar fascia might help ease the symptoms.

Plantar fasciitis can be a very painful condition which has a great impact on someone’s life.

Hopefully this article offers some help in the management of plantar fascitis.

Additional information regarding plantar fascitis can be found on the website: http://www.miltonchiropractic.co.uk

Plantar fasciitis is a health development that develops heel pain. It is stimulated when individuals stress their plantar fascia – a circle of tendons that helps to unite your heel bone to the toes. It is likewise used to sustain the arch of your foot. Individuals who hurt from this trouble will have a swollen and inflamed heel that will leave them in pain whenever they stand up or walk round.

It is most general for older middle aged individuals to hurt from this condition – but it is able to occur in younger people who commonly walk around for long periods of time. Athletes and soldiers are at an increased chance for this problem and can experience it in either one or both of their feet.

As we stated originally this problem is made when the fascia is strained. When not addressed unnecessary twisting will tear the fascia and stimulate swelling and extensive pain. This have the ability to happen when:

Your feet are flat or have high arches You are obese Your feet roll in when walking You walk or run too much You wear shoes that are too small Your Achilles tendon and calf muscles are too tight

One of the more common symptoms that you can suffer from when you have this condition is an intensive infliction that will take place whenever you move a few steps after sitting down for long periods of time or waking up in the morning. While the stiffness in your feet will lessen after a just a couple of steps the anguish will step-up through the day.

The doctor will have the means to diagnosis plantar fasciitis by testing how you are able to stand up and walk round. They will also need to know about health problems in the past that you have had, the symptoms you are experiencing, and the kind of physical activity you do. They will also need to take x-rays of your foot to discover if it might be a problem with the bones.

The most common cause of heel pain and heel spurs is a condition called Plantar Fasciitis (sometimes misspelled Planter Fascitis). This is Latin for inflammation of the Plantar Fascia. The Plantar Fascia is the broad band of fibrous tissue that runs under the foot and that forms your arch. Because of a number of different factors the plantar fascia are being overly stretched and this continuous pulling results in inflammation and pain at the heel, at the point where the ligaments insert into the heel bone.

Over-pronation of the feet (fallen arches + rolling inward of the feet and ankles), tight calf muscles, as well as ageing and being overweight are the main causes for the plantar fascia being overly stretched. There are many ways to treat Plantar Fasciitis, including cortisone injections and surgery. However, in most cases heel pain relief can be achieved through self-help by following a number of easy, simple steps, most of which are aimed at reducing the pulling of the plantar fascia.

1. Rest or reduce activity
When you have heel pain avoid any activity that can further aggravate the problem. This includes walking for long distances, walking up or down stairs, running, sports etc. If you want to keep fit swimming is the safest activity, until your heel pain has been treated properly. Or you can ride a bike or a stationary exercise bike. Basically, try to be as little on your feet as possible, allowing the plantar fascia to heal itself.

2. Cold & Hot therapy
Use an ice pack and apply it onto the sore heel for 5-10 mins at a time, 3 to 4 times per day. The ice will reduce the inflammation in the heel area. To help reduce any chronic inflammation, you can try alternating between ice and heat. Place an ice pack on the heel for 5 minutes and then switch to a hot pack (or hot water foot bath) for another 5 minutes. Do this for about 20-30 minutes per day and you’ll notice some considerable heel pain relief.

3. Roll a ball under the foot
Many people with Plantar Fasciitis experience a sharp heel pain in the morning, when taking the first steps after getting out of bed. This pain comes from the tightening of the plantar fascia that occurs during sleep. Stretching and massaging the plantar fascia before standing up will help reduce heel pain for the rest of your day! Massaging the plantar fascia can be done simply by rolling a tennisball (or rolling pin) under the foot, all the way from the heel to the toes. You may do this sitting down, applying a fair amount of pressure onto the arch, or even standing up as long this causes not too much discomfort. Keep rolling the ball or pin under the foot for about 5 minutes.

4. Stretch your feet with a towel
Stretching the plantar fascia is your next Plantar Fasciitis exercise, using a bath towel. Put a rolled up towel under the ball of one foot, holding both ends of the towel with your left and right hand. Next, slowly pull the towel towards you, while keeping your knee straight (the other knee may be bent). Hold this position for 15 to 20 seconds. Repeat 4 times and change to the other foot, if necessary. If you don’t have a towel handy, simply put your foot on your knee and grab your toes and pull them towards your shin, hold for about 10 seconds.

5. Stretch your calf muscles
Stand facing a wall with your hands on the wall at about eye level. Put one leg about a step behind your other leg, keeping your back heel flat on the floor. Make sure this leg stays straight at all times. Now bend the knee of the front leg slowly, lowering your body until you feel a stretch in the calf of the back leg. Hold the stretch for 15 to 20 seconds. Repeat 4 times. Do the same for the other leg.

Please make sure you don’t walk barefoot at home in the morning, as this will undo all the hard work! Wear shoes or supportive sandals as soon as you have done the Plantar Fasciitis exercises.

You can repeat any of these heel pain exercises during the day, if you wish. For example the tennis/golf ball rolling can be done as you watch TV or read the paper. There’s one more exercise you may want to do which is called the Achilles Tendon stretch. Stand on a step with both feet on the same step and slowly let your heels down over the edge of the step as you relax your calf muscles. Hold this stretch for about 15 to 20 seconds, then tighten your calf muscle a little to bring your heel back up to the level of the step. Repeat 4 times.
Please note that stretching exercises should create a pulling feeling, they should never cause pain!

6. Take an anti-inflammatory drug, like Ibuprofen
To ease your Plantar Fasciitis you can take an anti-inflammatory that contains Ibuprofen, like Nurofen or Advil. This is a short term fix that will help decrease the inflammation of the plantar fascia. You still need to do take all the other measures such as stretching, ice, orthotics etc to achieve long term pain relief from your heel problem. For many people Ibuprofen is pretty heavy on the stomach and therefore these drugs should be taken in moderation.

7. Lose some weight
As we get older we tend to put in a bit of extra weight. The combination of weight gain and ageing means we put a lot of extra tension on our muscles and ligaments in the feet, legs and back. Most people tend to over-pronate because of weight gain. Over-pronation (fallen arches) is the main cause of Plantar Fasciitis and heel pain. Therefore by losing weight you will decrease the tension on the plantar fascia.

8. Wear the right footwear
Supportive footwear is paramount, especially as we get older. Floppy footwear causes ankle instability during walking and contributes to the problem of over-pronation, leading to heel pain and other foot problems. A good supportive shoe should only bend at the sole in the forefoot area and should be firm elsewhere, especially the back section of the shoe (heel counter) should be firm. Many footwear companies advertise shock-absorption and cushioning as the major benefits of their (sports) shoes. Stability is far more important than cushioning!

9. Use a night splint
A night splint holds the foot at 90 degrees during your sleep. The aim of the splints is to keep your foot and calf muscles stretched during the night. Normally during rest the plantar fascia and calves tend to tighten and shorten. So when you wake up in the morning and take your first steps, the fascia are being pulled all of a sudden, causing the sharp pain in the heel.
The problem with night splints is that they can be quite uncomfortable. This is why they are so-called sock night splints on the market which are more bearable than rigid night splints.

10. Wear orthotics in your shoes
Research has shown that by far the most effective way to treat Plantar Fasciitis is wearing a corrective device inside the shoe. Orthotics are designed to correct the problem of over-pronation, the major cause of plantar fasciitis and heel pain. Orthotics support the arches and control abnormal motion of the feet, thereby greatly reducing the tension in the plantar fascia band. Especially when combined with daily exercises, orthotics will provide relief to the majority of Plantar Fasciitis sufferers. Orthotics can be obtained from a foot specialist (podiatrist). These are called custom orthotics and they usually quite hard. Nowadays there are softer orthotics on the market, which are made of EVA and which mould themselves to the wearer’s foot shape because of body heat and body weight. These softer orthotics are pre-made and available without a prescription from pharmacies and specialty websites.

Reasons Why Feet Sometimes Hurt

Human bodies are extraordinarily astounding; they are the perfect harmony of bones, flesh, and natural body fluids. Unique cushioning is provided in our joints and at crucial areas in any place on the body that bears weight. However, when this delicate harmony is interrupted by injury or certain conditions, excruciating pain can be the result. Heel spurs and plantar fasciitis are a couple of conditions of the feet that can cause a complete lack of mobility.

The Reasons You May Have Heel Spurs or Plantar Fasciitis

A heel spur is a pointed portion of bone that tends to grow out of the heel bone (calcaneus). They can be located either underneath or on the rear of the heel. When a heel spur is present, it can cause swelling and tearing of the softer foot tissues, which is made worse with simple movements or standing on the affected foot. When the location of the body growth is on the back side of the heel, it can irritate the Achilles tendon and cause tenderness and swelling in that zone. As cited on MedicineNet’s site, pressure on the ball of the foot makes this certain condition worse. Alternatively, when the heel spur is located under the heel, it aggravates the plantar fascia ligament, thus causing a condition called plantar fasciitis. MedicineNet describes this condition as being more of a problem when standing or walking.

Why Feet Can Get Heel Spurs and Plantar Fasciitis

Nevertheless, most times, heel spurs are caused by repetitive motion and excessive stretching of the plantar fascia ligament because of physical activity, and can also be caused by heavy lifting. Plantar-Fasciitis.org cites that certain types of arthritis as well as diabetes can raise the chances of developing either of these painful conditions. They warn that shoes that are too tight can also cause painful foot problems.

Recommended Treatments for Heel Spurs and Plantar Fasciitis

The goals in treatment of these conditions are to diminish the inflammation of muscles and ligaments as well as prevent re-injury. According to foot specialist Dr. William Shiel, Jr., MD, FACP, FACR, this can be accomplished in several ways:

Use of NSAID medicines As a last resort, surgery to remove the heel spur to allow for tissue and tendon healing Wearing circular shoe inserts for the heel Use of the best orthotic inserts available to properly align the foot and take pressure off of the affected areas Regularly icing on the affected regions Sufficiently-cushioned shoes

Have you ever feel nagging foot pain with the first couple of steps each morning? If you do, you might be one of the millions of Plantar Fasciitis sufferers in the planet. One of the symptom of this illness is intense heel pain in the morning. If you want to know how to treat plantar fasciitis, then keep reading the article.

Plantar fasciitis is one of the most common types of heel pain problems developed in most people. (including myself!) It is a painful inflammatory condition caused by excessive wear and tear to the plantar fascia area of a person’s foot.

The pains associate with it is usually felt on the underside of the heel and very often is most intense and painful when you begin your day – the time when you stand up from your bed after a night sleep. The pain will also resurface after a period of rest and inactivity. While women are more likely to suffer from it, it affects many who are overweight and plump. You are also at risk of getting plantar fasciitis if you holds a job that require a lot of walking or standing on hard surface for long period of time.

Resting your feet off the weight of your body is the primary method of plantar fasciitis treatment. Since many foot injuries are a result of muscles and tendon imbalances, stretching some of your muscle groups apart from strengthening can help to alleviate your heel pain problems. Your stretching exercises should concentrate on the Achilles tendon and calf muscles group. These exercises can be done at the comfort of your home to treat the condition and lessening the chance of recurrence pain.

Exercise 1: Bend 1 leg forward in a semi-lunge position and thrust the other leg straight back. Hold the position for a minute and switch leg.
Exercise 2: Stand on a step and balance on the balls of your feet with your heels hanging over the edge. Drop your heels below the step and hold for a minute.

There are some form of stretches and exercises that can be done to reduce the risk of recurrence of plantar fasciitis. Your physician may give you specific instructions for a suitable exercise program that is appropriate for you. Exercises for plantar fasciitis focus on stretching the Achilles tendon, calf, and plantar fascia. These stretches can be done whenever you experience pain from plantar fasciitis. Try them.

It is sometimes recommended that you warm up a little before doing plantar fasciitis stretches. An easy and not complex warm up is to walk up some stairs. Always ask your physician for advice on doing exercises and stretches for plantar fasciitis.

One of the plantar fasciitis stretches starts by standing about two feet away from a wall. Lean against the wall. With one leg bent comfortably, straighten the other leg, placing it about six inches behind you with the heel on the floor. Hold for ten seconds. You should feel a gentle stretch of the Achilles tendon in the extended leg. Switch positions and stretch the other leg. Repeat twenty times.

The second plantar fasciitis stretch starts with your toes against the wall with heels on the floor. Bring your hips nearer to the wall so that your other foot is at a 45 degrees angle. This will stretch the calf and the plantar fascia.

Sit on a chair. Rest the ankle of the injured foot on the knee of the opposite leg. Gently push the toes backward until you feel a stretch in the bottom of your foot.

Another exercise starts by leaning forward onto a countertop. Your feet should be spread apart with one foot in front of the other. Squat down. Keep your heels on the floor. Hold for ten seconds and relax. Repeat twenty times.

Sit on a table with your knees bent. Holding onto the ends of the towel, loop a towel under the ball of the foot. Keep knees bent as you gently pull the towel while flexing the foot upward. Try to press your foot against the towel.

If you experience pain in the morning, do the next simple exercise before getting out of bed. Lying on your back, using your big toes to try to write the alphabet in the air. After writing the alphabet, gently raise your big toes towards you.

Some people find massage helpful to reduce pain. One way to massage the area yourself is to rest the foot on a tennis or golf ball. Gently roll the foot over the ball. Rolling back and forth over the ball of the foot yields a gentle massage of the plantar fascia ligament. You can try using an empty tennis ball container that you filled with water and froze. The ice pack will smoothe the pain and the rolling action sort of massages the foot.

What Causes Painful Heel Bone Spurs & Plantar Fascistic?
Why Feet Can Hurt
Human bodies are truly amazing; they are the perfect blend of fluids, hormones, muscles, and bone tissue. Special cushioning is provided in our joints and at vital regions where weight-related pressure points exist. Nonetheless, when this delicate combination is stopped in its tracks by an injury or physical issue, severe pain can occur. Heel bone spurs and plantar fasciitis are 2 conditions of the feet that can impair immobility in people.
The Reasons You May Have Heel Spurs or Plantar Fasciitis
A heel spur is a pointed outgrowth of bone that has grown out of the calcaneus, or heel bone. They can be located either under or on the rear of the heel. When a heel bone spur is present, it can cause inflammation and tearing of the muscles of the foot, which is aggravated with regular activity or when pressure is placed on the afflicted foot. When the location of the body growth is on the back side of the heel, it can bother the Achilles tendon and cause tenderness and swelling in that zone. According to MedicineNet, pushing off of the ball of the foot makes this particular condition worse. Conversely, when the bony growth is in the area of the bottom of the heel, it aggravates the plantar fascia ligament, thus causing a condition called plantar fasciitis. MedicineNet describes this ailment as being made worse when applying pressure on the heel.
Causes of Heel Spurs and Plantar Fasciitis
Medical studies indicate that genetics can be a factor in heel spur development. some of the most common causes include repeat movements and too much stretch in the arch caused by sports or athletic activity, and can also be caused by heavy lifting. Plantar-Fasciitis.org reports that arthritis or diabetes can make it more likely for someone to develop either of these problems. They warn that shoes that are too tight can also cause painful foot problems.
Treatment Options for Heel Spurs and Plantar Fasciitis
The objectives in treatment of these injuries are to lessen the swelling of the soft tissues and ligaments as well as avoid re-injury. According to foot specialist Dr. William Shiel, Jr., MD, FACP, FACR, this can be done in several ways:
* Use of NSAID pills
* Using circular shoe inserts for the heel
* Properly-cushioned shoes
* Use of the best foot arch support available to properly align the foot and take pressure off of the affected areas
* Last resort is an operation to take out the heel bone spur to allow for tissue and tendon healing
* Applying ice on the affected regions

Heel pain, the most common foot complaint, affects millions of people around the world and often occurs as a result of daily activities and exercise. Plantar Fascists is the ailment that is often associated with the symptoms of Heel Pain and Heel Spurs. Other causes which can result in a heel pain can be a stress fracture, tendonitis, arthritis, nerve irritation, or, rarely, a cyst. Due to the fact that a heel pain can be caused due to any of the above-mentioned causes, it is vital to have heel pain properly diagnosed. This article will concentrate on the causes of heel pain, the symptoms, as well as the most effective treatment methods available nowadays. Plantar Fasciitis and its development: As mentioned earlier, Plantar Fasciitis is an ailment that is often associated with the symptoms of Heel Pain and Heel Spurs. The Plantar Fascia is a flat band of fibrous ligaments located under the foot that connects the heel bone to the toes. This dense strip of tissues acts like a bow-string that spans the arch of the foot to give it support. The Plantar Fascia generally takes the full load of the body when the foot is placed on the ground. Due the force exerted, the Plantar Fascia stretch out, flatten the foot and evenly distribute the weight of the body. Usually the Plantar Fascia is very tough and flexible to withstand forces transmitted during walking or running. However the normal function can be affected by excessive abuse of the feet, over-pronation, old age or being over-weight, because of which the Plantar Fascia exhibits micro tearing, leading to irritation, inflammation, and pain at the junction of the Plantar Fascia and calcaneus or heel bone. The Heel Spur is a bony growth on the heel, a result of the continuous pulling of the Fascia. This growth triggers pain in the surrounding tissues that get inflamed. Symptoms of Plantar Fasciitis The symptoms of Plantar Fasciitis are: Pain on the bottom of the heel? Pain that is usually worse upon? arising Pain that increases over a period of months? The Plantar Fascia contracts and becomes tight while in rest periods such as sleeping or sitting. However during initial movement or when one suddenly gets up, the Fascia must quickly expand to the rapid application of the weight, thereby resulting in micro-tearing the ligaments and the pain for a few minutes. Causes of Plantar Fasciitis Plantar Fasciitis can result due to various factors. Some of the most common ones are: Faulty structure of the foot. This factor covers both individuals with? overly flat feet or high-arched feet. Wearing non-supportive or ill-fitting footwear can also lead to this? ailment. Strenuous, repetitive, and arduous exercises like jumping and running can? be another cause for Plantar Fasciitis. Another major reason for Plantar Fasciitis can be obesity or pregnancy.? Achilles tendons and tight calf muscles can also lead to Plantar? Fasciitis. Other causes for Plantar Fasciitis can be: Bruises on the bone.? Excessive pronation (tendency of the foot to roll inward)? Stress Fractures.? Diagnosis and treatment of Plantar Fasciitis The diagnosis of Plantar Fasciitis is not easy and may involve a history of symptoms, physical examination, and other tests. With no real cure for Plantar Fasciitis, steps can be taken to prevent the pain. The Plantar Fasciitis can be treated through numerous traditional or non-surgical remedies such as: • Ice Packs – This should be applied to the inflamed area. • Night Splint – The mild stretching caused by night splints help in tensioning the calf muscles and Plantar Fascia. • Shock wave therapy – Shock wave pulses applied through a special machine helps in relieving the soreness. • Anti-inflammatory drugs – Ibuprofen drugs help in the relief of heel pain. • Cortisone injections – The steroid treatment is locally administered in the heel area. • Orthotic / Orthotic Insole Device – Orthotics realigns the foot and ankle-bones to their natural position and restores the normal foot function that alleviates not only foot problems but also ailments in other parts of the body. However it is advisable to undergo long-term treatment, which have been found to be quite effective as the Plantar Fascia excessively stretches due to over-pronation (fallen arches) and tightening of the calf muscle and ligaments and the above-mentioned remedial measures assist in relieving heel pain for a short-term only. Surgery as a means of cure should be the very last resort for the treatment of heel pain and should only be considered when all other conservative treatment has failed. In the surgical intervention the Plantar Fascia is partially released from the bone and any spur removed if found to be present. The pressure on the small nerves that traverse under the Plantar Fascia is released after proper identification of the cause. Prevention The state of Plantar Fasciitis is such that no matter what kind of treatment is undertaken, the primary causes that led to it may remain. Overweight being a major contributor of Plantar Fascia, steps should be taken to reach and maintain an ideal weight. Also wearing supportive shoes and using custom orthotic devices go a long way in giving relief from Plantar Fasciitis. The fact that heel pain affects a large number of people, most people respond to conservative, non-surgical therapy and heal within 6 to 8 weeks and only a minuscule percentage of the affected population go under the knife. The American Orthopaedic Foot and Ankle Society (AOFAS) conducted a two-year national study on treatments of heel pain. The study clearly demonstrated that the best course of cost-effective treatment is a strict regime of using “off the shelf” orthotics (arch supports) and a specific stretching program. The treatment resulted in 90 percent of patients experiencing substantial relief from heel pain symptoms. Did you find this article useful? 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The bottoms of things have, in general, been much maligned. The bottom of the barrel, bottom of the ocean, bottom of the slag-heap, and more bottoms are generally thought of as dark, dirty, or otherwise unpleasant places. But just think how important bottoms can be: the bottom of a ship, for instance, while sometimes sloshing with bilge-water, is nonetheless essential in a ship’s overall well-being. When its bottom fails, the ship goes down to the bottom of the ocean. Which is full of bottom-dwellers, as we well know.

The bottoms of feet are likewise very important. Think about it: all the weight of your body presses down on your poor, overworked feet. And towards the bottom of the foot is a band of tissue called the plantar fascia (a fascia is similar to a ligament) which connects to the bottom of your heel bone and fans out to the base of your toes. It helps support the structure of the bones at the bottom of your foot. Unfortunately, we don’t seem to appreciate what the plantar fascia does for us until it decides to go bottoms-up.

Like many tissues, the plantar fascia can become stretched over time, particularly in people with unusually high or low arches, or who are overweight, tend to do a lot of physical activity like running and jumping, wear shoes with little or no support, or have a tight Achilles tendon. Spending a lot of time on hard, flat surfaces (like a concrete floor) can also lead to problems. Plantar fasciitis may show up in either gender, although it most often affects people in late middle age (about 40 to 60).

When the plantar fascia stretches too far, it can develop small tears (or in extreme cases may even rupture). These tears make the plantar fascia irritated and inflamed, a condition known as plantar fasciitis.

1)Plantar fasciitis tends to manifest itself as pain at the bottom of the heel (although it can occur at any point along the arch of the foot) which is usually most severe when getting up in the morning (or in the afternoon if you like to sleep in a lot).

2)The pain often subsides during the day as you walk around a little, although it may become worse again if you’re on your feet a great deal, or if you sit for awhile and then try to stand again.

3)Many patients feel a searing or sharp pain when they first get on their feet after a period of rest. This may subside to a dull ache as the day goes on.

4)This condition tends to get worse over time, so you may start off with very little pain that gradually progresses to severe over a period of months. Your arches may also gradually flatten as the plantar fascia stretches out.

5)Additionally, you may develop a heel spur (a bone growth along the bottom of your heel bone). In the past, it was thought that the spur contributed to the pain, but, since many people with heel spurs experience no symptoms, this is no longer thought to be the case.

When you go in to see your podiatrist about the pain in the bottom of your heel, be sure to come prepared to answer questions (and ask questions of your own, of course). Your doctor will probably want to know a history of your symptoms and will perform a physical exam of your foot to check for swelling and redness. He or she may also check for tenderness on the foot to find out where the pain is coming from. You may need to get X-rays to check for other possible sources of your pain (such as stress fractures).

Getting your plantar fascia to feel better usually revolves around some conservative treatments. These may include anti-inflammatory medication (such as ibuprofen), ice (20 minutes on the foot over a thin towel, then 40 minutes off), doing exercises to stretch the calf muscle, wearing shoes that give better support to the foot (such as those with a slightly elevated heel and decent arch support), avoiding going barefoot, and giving your feet a rest by avoiding activities that stress them out (like certain sports or standing for long periods).

Persistent pain may need slightly more extensive treatment, such as the use of orthotics (custom-made shoe inserts), a walking cast to keep your foot immobile or a night splint to stretch the plantar fascia out. Your podiatrist may also suggest physical therapy (including extracorporeal shock wave therapy), padding and strapping (or taping) the foot to ensure things stay in their proper positions, and cortisone injections (although you don’t really want to have more than one of these, since repeated injections can weaken the fascia).

Although it’s rare, very persistent plantar fasciitis may need to be addressed with surgery if it fails to respond adequately to the above treatments. Surgery usually involves releasing the fascia from the bottom of the heel bone, although this may weaken the arch of the foot, and may have other complications, including as infection and nerve injury. Be sure to discuss all possible treatments with your foot doctor.

After receiving treatment, your plantar fascia should stop causing you so much pain. But really, the whole experience should make you appreciate the bottom of your foot that much more. And then you can thank it. From the bottom of your heart.