Plantar fasciitis is commonly found in athletes and runners as a result of their extensive running and exercise.  Plantar fasciitis occurs when the plantar fascia, which is the long, flat ligament on the bottom of the foot, stretches irregularly and develops small tears that cause the ligament to become inflamed.  The pain that occurs from the inflammation is most commonly found to occur in the early morning after a long period of rest.  Putting sudden weight on the foot after it's been at rest of an extensive period of time causes stress on the area and sudden pain will occur.  However, the pain should subside once the foot has been walked on for a while.  

Since runners are especially prone to developing plantar fasciitis, extra precautions need to be taken to help prevent this problem from occurring.  Utilize the tips below to help reduce the chances of developing plantar fasciitis:

• Rest regularly.  When running long distances, it's important to rest intermittently in order to relieve constant stress on the plantar fascia.
• Change your routine gradually.  Do not suddenly start an aggressive routine.  Ease into a new routine by gradually increasing distance and difficulty. 
• Stretch.  Make sure to stretch the entire body before running and pay special attention to the plantar fascia. 
• Choose proper shoewear.  Runners should always wear shoes that fit properly and support the heel and arch of the foot. 

When feeling the type of pain that occurs with plantar fasciitis, it is best to stop running.  Additional strain on the heel will aggravate the area even more and will cause the pain to become even more severe.  Alternative exercises, such as swimming and pool exercises, are recommended so additional strain is not put on the plantar fascia. 

If you have experienced or are experiencing symptoms of plantar fasciitis, please contact us to make an appointment.    

Plantar fasciitis is one of the most common foot conditions that people suffer from and it's the number one condition that we see patients for in our office.

Patients with plantar fasciitis will find that they experience many different symptoms, but the tell-tale sign of plantar fasciitis is heel pain first thing in the morning, which normally results in a limp.   

There have been many effective treatments for plantar fasciitis. But, it can be recalcitrant to traditional treatments.  

Mechanical treatments include:

• stretching
• avoiding going barefoot
• wearing supportive shoes
• prescription orthotics or over-the-counter arch supports
• using a night splint
• taping 

Treatments addressing inflammation may include:

• icing
• cortisone injections
• oral anti-inflammatories
• physical therapy modalities such as therapeutic ultrasound and electrical stimulation

Recalcitrant cases may be treated with platelet rich plasma injections, shockwave therapy and surgery. Surgery is usually the last resort and can include plantar fascial release or a gastrocnemius recession.

In November of 2008, Dr. Lucia Sconfienza out of the University of Genoa in Italy gave his presentation on dry needling for plantar fasciitis at the radiological society of North America annual meeting in Chicago. He reported a 95% success rate for treatment of plantar fasciitis with this technique. Since this time, there has been more interest in this approach in the United States. At Issaquah Foot and Ankle Specialists, we have been providing this procedure since December 2008. Our clinic has developed a protocol to accompany this procedure. Ultrasound guidance is used to direct the procedure and ensure that it is safe. The procedure involves repeated probing during the injection that causes microtrauma and some internal bruising. This releases platelets that have associated growth factor and this in turn stimulates the body to heal itself. The procedure itself is actually quite low-cost compared to some of the other alternatives such as shockwave therapy and surgery.

Many people mistake the diagnosis of heel spur with that of plantar fasciitis.

A neuroma is an inflamed nerve that is caused by a compression or trauma.

Tendons are bands of connective tissue that connect the muscles to the bones and allow those muscles in the leg to move the foot.