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WHAT IS PODIATRY?
Podiatric medicine focuses on diagnosing, treating, and preventing foot and ankle problems, such as plantar fasciitis. Your podiatrist (doctor of podiatric medicine) is highly trained through years of study and clinical practice, including a bachelor’s degree program and four years of podiatric medical school. Podiatrists may also have one or more years of residency training, studying other aspects of foot care and surgery. Podiatrists continue to stay informed about the latest research and developments in the field. In treating your feet, your podiatrist may also work with your other health care providers to give you appropriate and comprehensive care.
Footnote
When your foot bears your body weight, the plantar fascia is pulled tight like a bowstring.
WHAT IS PLANTAR FASCIITIS?
The plantar fascia is a ligament-like band running from your heel to the ball of your foot. This band pulls on the heel bone, raising the arch of your foot as it pushes off the ground. But if your foot moves incorrectly, the plantar fascia may become strained. The fascia may swell and its tiny fibers may begin to fray, causing plantar fasciitis.
Causes
Plantar fasciitis is often caused by poor foot mechanics. If your foot flattens too much, the fascia may overstretch and swell. If your foot flattens too little, the fascia may ache from being pulled to tight.
Symptoms
With plantar fasciitis, the bottom of your foot may hurt when you stand, especially first thing in the morning. Pain usually occurs on the inside of the foot, near the spot where your heel and arch meet. Pain may lessen after a few steps, but it comes back after rest or with prolonged movement.
Related Problems
A heel spur is extra bone that may grow near the spot where the plantar fascia attaches to the heel. The heel spur may form in response to the plantar fascia’s tug on the heel bone. Bursitis is the swelling of a bursa, a fluid-filled sac that reduces friction between a ligament and a bone. Bursitis may develop if a swollen plantar fascia presses against a plantar bursa.
Medical History and Physical Exam
Where and when does your foot hurt? Your podiatrist may first ask about your symptoms. Then he or she may feel for damaged ligaments, inflamed tendons, and displaced bones or joints. Your podiatrist may also watch you walk to see if your symptoms are caused by incorrect foot movement.
Testing
X-rays of your foot may be taken, or you may have a bone scan to confirm a suspected heel spur or a stress fracture of the heel bone. To check for plantar fasciitis and related problems, your podiatrist may press the bottom of your foot near the heel.
CAN MY PODIATRIST HELP?
Reducing symptoms is your podiatrist’s first goal. Then he or she works to correct the cause of your problem. If your pain is due to poor foot mechanics, custom-made shoe inserts (orthoses) may help.
Reduce Symptoms
To relieve mild symptoms, try aspirin, ibuprofen, or other medications as directed. Rubbing ice on the affected area may also help. To reduce severe pain and swelling, your podiatrist may prescribe pills or injections. Physical therapy, such as ultrasound or stretching exercises, may also be recommended. To reduce symptoms caused by poor foot mechanics, your foot may be taped. This supports the arch and temporarily controls movement. Night splints may also help by stretching the fascia.
Control Movements
If taping helps, your podiatrist may prescribe orthoses. Built from plaster casts of your feet, these inserts control the way your foot moves. As a result, your symptoms should go away.
If Surgery Is Needed
Your podiatrist may consider surgery if other types of treatment don’t control your pain. During surgery, the plantar fascia is partially cut to release tension. As you heal, fibrous tissue fills the space between the heel bone and the plantar fascia.
WHAT CAN I DO?
You can’t stay off your feet altogether, but you can reduce overuse and the risks that come with it. Also, be sure to follow your podiatrist’s treatment plan. Take medications as directed, and wear orthosis if you have them, even while at home.
Reduce Overuse
Every time your foot strikes the ground, the plantar fascia is stretched. You can reduce the strain on the plantar fascia and the possibility of overuse by following these suggestions:
- Lose any excess weight.
- Avoid running on hard or uneven ground.
- Wear shoes or house slippers that support your arch.
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