plantar fasciitis. Learn how to prevent and treat this inflammation of the foot20 September 2022
La Plantar fascia it is stretch fabric band which runs from the calcaneus (the heel) to the metatarsal area (under the fingers). The inflammation of said structure, is what we know as Plantar fasciitis.
WHAT IS PLANTAR FASCIITIS?
La Plantar fascia It has a great biomechanical function to walk. Along with other foot structures, it is responsible for:
- Maintain the plantar arch.
- Absorb and return energy It occurs when the foot hits the ground.
- Protect the metatarsals, avoiding excessive dorsiflexion of the fingers.
IS IT A COMMON PROBLEM?
Plantar fasciitis is a fairly frecuente in the sports population (runners, athletes, soccer players, etc.). It can also appear from 45 years. en people who do not practice sports.
Some studies state that around 10% of the population may suffer from it at some point in life.
IS PLANTAR FASCIITIS MORE COMMON IN MEN OR WOMEN?
among the population not athlete, is more common in women, while in the population sportsman That one percentage is equal.
Here at the of there is a direct relationship between Plantar fasciitis and shortening of the posterior leg muscles. The greater the shortening, the more chances of generating plantar fasciitis. One of the causes that more shortening of the posterior chain produces in a woman is the continued use of heeled shoes. That is why it is very important, especially for young women, alternate high-heeled shoes with much flatter shoes to prevent the leg muscles from "getting used" to the height of the heel and shortening.
Instead, in the ladies who have been using a high-heeled shoe high, the advice will be to try decrease the height very progressively, but never going from a high heel to a flat. The increased tension that will occur in the Achilles tendon, calves, etc., will exponentially increase the chances of suffering from plantar fasciitis, Achilles tendinitis, low back pain, etc.
WHAT SYMPTOMS CAN MAKE US SUSPECT THAT WE SUFFER PLANTAR FASCIITIS?
El symptom main is a Acute pain in the internal area of the heel (It is the area of insertion of the plantar fascia). That pain is usually more intense in the first steps we take when we get up, because the fascia with the rest of the night becomes "shorter" and when taking the first steps it pulls harder. Once we have walked a little, the fascia stretches and the discomfort usually decreases.
In the case of athletes, in the initial stages of fasciitis, the pain may only appear in the morning and after sports. We must bear in mind that when the first symptoms appear we must begin to take measures because we have many possibilities that the fasciitis gets worse and there comes a time when it is very limitation for sports life and even for the normal life of a person who has to stay long time standing or walking.
Intense pain in the heel area when we get up in the morning is the main symptom of plantar fasciitis.
WHAT IS THE DIFFERENCE BETWEEN PLANTAR FASCIITIS AND A HEEL SPUR?
Sometimes it is confused Plantar fasciitis with the calcaneal spur. when in evidence radiological we observe a calcification of the postero-internal tubercle of the calcaneus then we speak of calcaneal spur.
This X-ray shows a kind of "pointed projection" that comes out from the heel towards the inside of the foot, which would be a spur. If said calcification does not appear in the tests, we speak of Plantar fasciitis.
However, symptoms and treatment will be very similar. He spur It appears by maintaining continuous traction of the fascia against the calcaneus. This tension causes early stage plantar fasciitis, and if it is maintained over time, it will possibly generate the calcaneal spur. In both cases, the goal of treatment will be “loosen” the fascia so that inflammation decreases and therefore the pain.
It is very important to do the diagnosis as soon as possible and thus be able to start carrying out all the actions aimed at "loosening the fascia" as soon as possible. The sooner we start the treatment, top results we will obtain in the short and medium term.
It can be affirmed, although with some nuances, that the calcaneal spur is the natural continuation of plantar fasciitis maintained over time.
DOES THE TYPE OF TREAD INFLUENCE?
La way of stepping is without a doubt one of the main causes to suffer a Plantar fasciitis. In those patients with a greater tendency to pronation (that the load of the foot tends to move towards the inner side) is where we will most likely find this pathology.
On the other hand, note that the types of feet in which we will most commonly find fasciitis are in the cavus feet (bridge higher than normal) and in the valgus feet (feet that tend to collapse inwards). Although they seem totally different feet, in both there is a decline in support of the external lateral area, leaving the fascia in a situation of increased tension.
Knowing how your stepping is and carrying out the appropriate treatment can prevent plantar fasciitis.
HOW TO SOLVE PLANTAR FASCIITIS?
The biggest difficulty in solving this problem definitively is that often, we focus more on the symptoms than on the causes. La inflammation, which is the cause of the pain, it is possible to treat it in many ways, but the important thing is that decrease the tension generated in the plantar fascia.
In many cases, the increased voltage generated in the plantar fascia is due to shape of the foot or the way of stepping (or both aspects together). If we only treat the acute phase of fasciitis, reducing the inflammation of the fascia insertion, the patient upgrade to but possibly it will get worse again after you have been with your usual physical activity for a while.
Discover three exercises (myofascial release, stretching and strengthening) to relieve symptoms of plantar fasciitis without leaving home this article.
IS THERE A POSSIBILITY OF SUFFERING AGAIN PLANTAR FASCIITIS?
If NO we discover and modify the cause that caused the first plantar fasciitis we have a good chance of suffer it again. The important thing is to know why this discomfort appears, what factors cause the problem and solve the "root" pathology.
In this infographic, we summarize all the information about this common pathology.
WHAT IS THE USUAL TREATMENT FOR PLANTAR FASCIITIS?
El Usual treatment is usually combined anti-inflammatory medication with different physiotherapy treatments aimed at reducing inflammation in the acute phase.
In a second phase, which should be started as soon as possible, a correct biomechanical study of walking or tread to assess whether the cause of the fasciitis is related to the patient's way of stepping. If so, it is necessary to design and manufacture custom plantar fasciitis insoles that allows the fascia to "loosen" so that when the acute phase is over, we can restart the activity with many less chance of relapse.
Once the acute phase is over, it is very important that the patient adopts correct habits on stretching and on the use of footwear that you should use both for normal life and for sports activity.
It is important to note that there is a wide range of “biomechanical studies of gait”, but they are not all the same. For example, the study carried out in a sport Shop is exclusively aimed at advising us on the type of slipper more indicated for us, but at no time does it have clinical validity nor is it aimed at relating our way of stepping with a present or future injury.
In turn, in the orthopedics, it is important to know that the orthopedic technician is not qualified, neither technically nor legally, to issue any type of diagnosis or prescribe the use of templates. Its mission is exclusively to manufacture a treatment following the precise instructions of the prescription issued by a traumatologist, podiatrist, rehabilitation doctor, etc.
Just as a well indicated, designed and manufactured insole can greatly improve our quality of life, it is important to know that an inappropriate insole can aggravate the pathology.
Therefore, the ideal is to go to a specialized podiatry clinic where the patient will find the media and qualified professionals in order to issue a correct diagnosis about your footing and possible treatment.
IS THERE ANY NEW THERAPEUTICS TO TREAT PLANTAR FASCIITIS?
La technology offers us more and more tools both to deal with acute phase how to improve the design and manufacture of custom templates very precise. Techniques like EPI or shock waves have shown that they can be very effective in the treatment of the acute phase.
On the other hand, the application of platelet rich plasma (PRP) or, put another way, the use of plasma-derived growth factors has proven its effectiveness in acceleration of healing and tissue regeneration in the treatment of plantar fasciitis.
Regarding the custom templates, at Podoactiva we have developed systems such as the 3D Scan Podoactiva, worldwide patented. Allows you to get a virtual 3D foot cast to make a template as adapted as possible to the plantar fascia under load of the patient.
Ultimately, the Plantar fasciitis It is one of the most frequent pathologies that we treat in consultation. It is very important to know the reason that causes this pathology, go to a specialized podiatrist and apply the proper treatment.
VICTOR ALFARO SANTAFE
Podoactiva General Manager
Podiatry Manager Sanitas-Real Madrid
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