Heel Pain in the Morning? A Look at Plantar Fasciitis.

Recently, NFL quarterback Peyton Manning was sidelined due to a partial tear of his plantar fascia, a ligament in the foot. It was reported that Peyton Manning had been battling plantar fasciitis for some time and that it had then progressed to a partial tear.1

Plantar fasciitis is defined as inflammation of the plantar fascia, but it is better described as a degeneration of the plantar fascia as a result of repetitive trauma. More than two million people in the United States are treated for plantar fasciitis each year, and it is the leading cause of heel pain.2

What Is the Plantar Fascia?

image1It is a thickened, fibrous band of connective tissue that attaches from the bottom of the heel to the base of the toes. The main functions of the plantar fascia are to provide support to the arch of the foot and to act as a shock absorber.2

Causes.

Plantar fasciitis is typically a result of overuse injuries. The repetitive movement of walking and/or running can cause microtears in the plantar fascia, leading to heel pain. Risk factors for plantar fasciitis include obesity or sudden weight gain, flat feet, reduced buttock or core strength, decreased ankle dorsiflexion (the ankle’s ability to bend toward the shin), working in an occupation that requires prolonged standing, and improper or excessively worn footwear. All of these factors put increased strain on the plantar fascia.2

Signs and Symptoms.

The classic presentation of plantar fasciitis is heel pain on the sole of the foot. The pain is usually described as being at its worse when taking a few steps in the morning or after sitting for a long period of time, and then it diminishes after walking for a bit.2

Treatment.

Treatment for plantar fasciitis typically takes between 6 and 18 months to resolve completely, although early recognition is key, as it leads to a significant reduction in treatment time and a high probability that the condition will resolve with conservative therapies. Conservative therapies include removing or altering the activities or factors that are creating inflammation and physical therapy for the lower extremity. Physical therapy to help with plantar fasciitis could include: strengthening and stretching the hip, foot, and ankle; manual therapy; and switching to proper footwear to support the arch of the foot, along with night splinting. For temporary pain relief, anti-inflammatories may be prescribed and, in more chronic cases, corticosteroid injections may be an option. However, multiple corticosteroid injections have been associated with fascial weakness and can lead to rupture, much like what Peyton Manning is dealing with. In extreme cases, when all other options have been exhausted, surgery may be performed to release the plantar fascia.2

Plantar fasciitis is a self-limiting condition, and about 80 percent of all cases are resolved within a year.2 Typically, the sooner physical therapy can begin to reduce inflammation and pain, the better the outcome. For more information or to ask questions about plantar fasciitis, contact us at info@sptny.com.

References:

  1. Adam Schefter. “Peyton Manning Has Torn Plantar Fascia in Left Foot, Had Trouble Walking.” ESPN, November 16, 2015. http://espn.go.com/nfl/story/_/id/14143938/peyton-manning-denver-broncos-torn-plantar-fascia-left-foot.
  2. Mario Roxas. “Plantar Fasciitis: Diagnosis and Therapeutic Considerations.” Alternative Medicine Review 10, no. 2 (2005): 83–93.