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Mark A. Wolgin, MD, Orthopaedic Surgeon

Specialist (Fellowship Trained) in Spinal and Foot/Ankle Surgery, Albany, GA, Office Phone 229-883-4707

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Plantar Fasciitis   
(for video on this condition, click below).






"Plantar" refers to the sole of the foot.  "Fascia" is a thick connective tissue (like gristle) on the sole of the foot that helps suport the arch.
 
 
 
 
The suffix "itis" refers to inflammation of that part.  Therefore, fasciitis means inflammation of the fascia. 
 
 
 
The plantar fascia would be the layer first encountered after removing the skin and fat from the sole of the foot.
 
 
 
The stresses on this fascia, which helps support the arch structure of the foot, is spread over a wide area as it inserts at the bases of the toes, but is concentrated at its insertion in the heel bone (calcaneus).
 
A small tear can occur at the insertion of this fascia near the heel, starting the repair process which we recognize as inflammation.
 
 
 
 
 
 
 As part of the healing process, the body makes repair tissue.  Since the injury or tear is occurring right where the fascia attaches to the heel bone, often as part of the repair process, a small bit of bone is formed in this repair tissue.  This bone can be seen on the xray as a small heel spur.  The spur itself is not dangerous and is not sticking into the ground, but indicates that the body is trying to repair an injury in this area.
 
The principles of treatment involve stretching the tissue so it doesn't stay torn.
 
 
Achilles stretching technique:
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Heel to be stretched is behind, heel remains in contact with ground.
 
Leg not being stretched has knee bent in front.
 
Things to avoid:
--lifting back heel off ground
--bouncing (keep sustained stretch)
--rotating back foot outward (keep toes pointed to the wall). 
 
 
 
 
 
The Achilles tendon can be stretched also by using a step, resting the forefoot on the step, and allowing the heels to move in a downward direction by gravity.
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Another treatment is to stretch the plantar fascia before putting your foot on the floor after sitting for a prolonged period and upon first waking up in the morning.
 
The technique involves trying to stretch the toes and ankle upwards.  Usually, the plantar fascia can be felt and massaged. 
 
The stretch needs to be done for about a minute.
 
 
 
 
 
 
 
 
 
 
As another option, the plantar fascia can be kept in a stretched position by use of a splint worn at night when sleeping.
 
 
 
 
 
 
 
 
 
 
 
 
On occasion, when non-surgical treatments have failed, surgery is required.