Carlos R. Rodriguez, MD
Plantar fasciitis is a condition that causes pain at the bottom of the foot between the ball of the foot and the heel. It is due to inflammation of a tough layer of tissue called the plantar fascia.
There are multiple factors that may increase the chances of getting plantar fasciitis. These include wearing high heels, gaining weight, and an increase in walking, standing, running or stair-climbing. Exercising on a harder surface or wearing shoes with little arch support and heel cushion may also make it more likely to develop this condition. Finally having high or low arches can also be a contributing factor.
Typically the pain improves when you rest and during the night while you sleep only to become worse when you first get out of bed in the morning. The inflamed fascia shortens and starts healing through the night as your feet relax. Then you stretch it when you start standing or walking and the pain returns.
Our physicians at the Johns Hopkins All Children's Sports Medicine clinic will ask you about your symptoms, examine your feet and may order x-rays of your foot. It is important to understand that although we may see a heel spur on the x-ray, the spur is not the reason for the pain but rather a consequence of the inflammation of the fascia.
The treatment of plantar fasciitis includes rest, icing your heel for a few minutes several times a day, a home exercise and stretching program, and wearing heel cushions in your shoes. You may also be prescribed an anti-inflammatory medication and orthotics if you are found to have abnormal arches.
In cases where the above does not relieve your symptoms you may be referred to physical therapy for more advanced stretches, exercises and possibly taping to support the bottom of your foot. Some patients are also prescribed splints to be worn at night to keep their feet stretched while sleeping. An injection with cortisone can be used in patients with severe pain and not improving with all of the above treatments.
Our goal is to get you back to your sport as safely and quickly as possible. In general, the longer you have symptoms before you start treatment, the longer it will take to get better.