plantar fasciitis

Plantar fasciitis is an inflammation of the tendon attachments to the heel (calcaneus or os calcis). It produces point tenderness at either the attachment of the Achilles tendon to the heel or on the underside of the heel (plantar surface) where the toe flexor muscles attach to the bone. If there is inflammation of the Achilles tendon attachment, it may be confused with Sever disease, but the medical management is the same, so little harm done. The cause of the inflammation is repetitive trauma caused by the tremendous forces generated in running and jumping, forces that are concentrated on a very small area of attachment of tendon to the bone.

Plantar fasciitis is typically painful with the first few steps in the morning, then improves with activity. Later in the day, when activity lessens again, the soreness and stiffness return. Pain when the toes are passively pushed upwards (dorsiflexion) is typical. Xrays, if they are taken, may show calcium deposits in the tendons of the sole of the foot, or perhaps a bone spur at the tendon attachment point.

Treatment is relative rest - not so much running and jumping - as well as icing after excercise and nonsteroidal anti-inflammatories (NSAIDs) such as ibuprofen or naprosen. (Remember always to take these with food.) For plantar fasciitis of the sole of the heel, a horseshoe-shaped heel pad is often helpful - these are available in any drugstore. Heel cord and foot sole stretching exercises can be helpful. Occasionally corticosteroid injection is warranted.

See also Osgood-Schlatter disease for a condition with similar cause and treatment.

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