Plantar Fasciitis and Heel Spur Syndrome
Patrick D. Kain ATC/L
Licensed Athletic Trainer
Buffalo Grove High School, Buffalo Grove, Illinois
Happy New Year to all of you. I
trust that even with the snow falling, everyone is still managing to get some
mileage in on the roads. Look out for those crazy drivers! Track season is just
around the corner; good luck to all of you; I hope you will have a healthy and
successful season! In this article, I would like to share some information
regarding the most frequent hindfoot problem among distance runners, a condition
known as Plantar Fasciitis, or Heel Spur Syndrome.
What is it?
The Plantar Fascia is a dense fibrous tissue which runs from the
calcareous (heel) along the bottom of the foot and inserts under the metatarsal
heads. This fascia can become irritated anywhere along its course, but the pain
is often located under the heel.
Signs and Symptoms
Often
the pain intensifies when getting out of bed in the morning when weight is first
put on the foot. However, the pain lessens after a few steps. The pain is
often reproduced if the toes are dorsiflexed (pulled up). In plantar fasciitis,
the pain is more severe when running on the balls of the feet, whereas if pain
is more intense on heel contact, a condition called Heel Spur Syndrome could be
present. Heel Spurs result from excessive ossification (bone formation) due to
the constant pulling of the fascia at the point where the fascia inserts on the
bottom of the heel, and can be extremely painful.
Causes
A
number of anatomical and biomechanical conditions have been studied as possible
causes of these two related conditions. These include leg length discrepancies,
over - pronation, inflexibility of the longitudinal arch, as well as tightness
of the achilles tendon. Ill-fitting running shoes, stride length, and running
surfaces have also been linked to this condition. To date, no one factor has
been named the single cause of this condition.
Management
If
you begin to notice any of these symptoms before the condition gets to be
unbearable, you may be able to successfully treat it. If the pain is already
too great, a visit to an Orthopedist or Podiatrist may be in order to receive an
X-ray and further evaluation, including the possibility of being fitted for foot
orthotics. Conservative treatment usually consists of attempting to relieve the
irritation by rest or modifying your workouts (decreased mileage and intensity,
stationary bike with a low seat to limit ankle motion, or swimming, if
tolerated). Furthermore, light stretching of the achilles tendon as well as the
plantar fascia (by pulling the toes up) 3-4 times per day, combined with ice
packs for 20 minutes, 3-4 times per day for 2-3 days. After that time,
alternating heat and ice and continued stretching may provide additional pain
relief and encourage healing. A medial longitudinal arch pad should also be put
in the shoes to provide support. Loose, floppy shoes or sandals may irritate
the injury even more due to excessive stretching of the arch, so firm-soled
shoes (i.e. straight-lasted, motion control shoes) should be worn whenever not
working out. Anti-inflammatories, as prescribed by your physician, or for you
minors, as given by your parents, have also been found to help this condition.
As always, being fitted properly for shoes and utilizing inserts if
necessary can help prevent Plantar Fasciitis or other running injuries. Consult
your friends at Running Unlimited for further information regarding proper shoe
fitting. Have a great winter, and see you all in April at the Renegade Run
European Cross-Country meet at Hamilton Reservoir in
Palatine!
|
click to learn more.
