Early treatment of foot injuries typically includes the use of anti-inflammatory
medication, icing, stretching activities, and heel inserts and splints. Cortisone
injections may be necessary to achieve satisfactory healing and retard inflammation.
In later stages of the rehabilitation process, typically after the first week, ice
should be discontinued and replaced with heat and massage.
It is imperative that any activity known to produce irritation or trauma to the
plantar fascia be immediately discontinued, including any activity involving repeated
impact of the heel on a hard surface, particularly, running. Should pain associated
with the injury persist, additional diagnostic studies should be undertaken to rule
out other, more exotic causes of heel pain including stress fractures, nerve compression
injuries, or collagen disorders of the skin.
In unusual cases, surgical intervention is necessary for relief of pain from foot
injuries. These should only be employed after non-surgical efforts have been used
without relief. Generally, such surgical procedures may be completed on an outpatient
basis in less than one hour, using local anesthesia or minimal sedation administrated
by a trained anesthesiologist. In such cases, the surgeon may remove or release
the injured and inflamed fascia, after a small incision is made in the heel. A surgical
procedure may also be undertaken to remove bone spurs, sometimes as part of the
same surgery addressing the damaged tissue. A cast may be used to immobilize the
foot following surgery and crutches provided in order to allow greater mobility
while keeping weight off the recovering foot during healing. After removal of the
cast, several weeks of physical therapy can be used to speed recovery, reduce swelling
and restore flexibility.
Prevention
- Warm up properly: This means not only stretching prior to a given athletic
event, but a gradual rather than sudden increase in volume and intensity over the
course of the training season. A frequent cause of plantar fasciitis is a sudden
increase of activity without suitable preparation.
- Avoid activities that cause pain: Running on steep terrain, excessively
hard or soft ground, etc can cause unnatural biomechanical strain to the foot, resulting
in pain. This is generally a sign of stress leading to injury and should be curtailed
or discontinued.
- Shoes, arch support: Athletic demands placed on the feet, particularly
during running events, are extreme. Injury results when supportive structures in
the foot have been taxed beyond their recovery capacity. Full support of the feet
in well-fitting footwear reduces the likelihood of injury.
- Rest and rehabilitation: Probably the most important curative therapy
for cases of plantar fasciitis is thorough rest. The injured athlete must be prepared
to wait out the necessary healing phase, avoiding temptation to return prematurely
to athletic activity.
Strengthening exercises: Below are two simple strength exercises to help
condition the muscles, tendons and joints around the foot and ankle.
Plantar Rolling: Place a small tin can or tennis ball under the arch of the
affected foot. Slowly move the foot back and forth allowing the tin can or tennis
ball to roll around under the arch. This activity will help to stretch, strengthen
and massage the affected area.
Toe Walking: Stand upright in bare feet and rise up onto the toes and front
of the foot. Balance in this position and walk forward in slow, small steps. Maintain
an upright, balanced posture, staying as high as possible with each step. Complete
three sets of the exercise, with a short break in between sets, for a total of 20
meters.
The stretches above are just a small sample of the many stretches in The Stretching
Handbook. In fact, if you suffer from plantar fasciitis or other foot and ankle
problems, there are over 22 different stretches that will help you. Remember...
Stretching is one of the most under-utilized techniques for improving athletic performance,
preventing sports related foot injuries and properly rehabilitating sprain and strain
injury. Don't make the mistake of thinking that something as simple as stretching
won't be effective.