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Plantar Fasciitis Explained 
Plantar Fasciitis is the most common foot complaint and the main cause of heel pain, heelspurs and also arch pain. Millions of people suffer from Plantar Fasciitis, especially the over50's. Fortunately for 80-90% of Plantar Fasciitis sufferers there are some very effectivetreatment solutions available.
Definition:
 Plantar Fasciitis (pronounced "plantar fash-eee-eye-tiss") means litterally "inflammation of the plantar fascia". Plantar Fasciitis is also called "Policeman's Heel". Plantar Fasciitis is oftenassociated with calcaneal spurs (heel spurs).
Symptoms:
 Plantar Fasciitis usually presents itself as a sharp pain, experienced at the underside or frontof the heel bone. Often the pain is worse with your first steps when getting out of bed in themorning. For most people Plantar Fasciitis pain is more severe following periods of inactivityor rest, when getting up. After a short while the sharp pain subsides, turning into a dullache. In the morning, stiffness and swelling in the heel area may be present.The condition starts gradually with mild pain at the heel bone often referred to as a stonebruise. You're more likely to feel this after (not during) exercise and walking. Most peoplewill put up with heel pain for at least 6 weeks before seeking (self)treatment, informationand/or advice.If Plantar Fasciitis is left untreated, it may become a chronic condition and treatment willbecome far more difficult. Also, Plantar Fasciitis sufferers tend to avoid putting weight on thesore heel and will try to walk on the forefoot in order to avoid pressure on the heel. With thisabnormal walking pattern one could easily develop problems in the knees, hips or back.
Anatomy:
 The Plantar Fascia is a thick, fibrous band of connective tissue that runs from the heel bone(calcaneus) along the sole of the foot like a fan, being attached at its other end to the baseof each of the toes. It is a tough and resilient ligament structure that performs a criticalfunction during walking and running.The Plantar Fascia acts as a 'bowstring' connecting the ball of the foot to the heel. It formsthe longitudinal arch of the foot and helps to lift the heel off the ground to prepare the footfor the 'take-off' (propulsive) phase of the gait cycle. During walking, at the moment theheel begins to lift off the ground, the Plantar Fascia endures tension that is around twice ourbody weight. The Plantar Fascia also act as a natural shock-absorber during walking andrunning.
Causes of Plantar Fasciitis:
 Plantar Fasciitis is Latin for inflammation of the Plantar Fascia. This inflammation occurs atthe point where the fascia attaches to the calcaneus (also known as the heel bone).
 
So what causes the Plantar Fascia to become inflamed? There are a number of variousreasons for this to occur. For example, you are more likely to develop Plantar Fasciitis, if youare over 50 years old, if you're overweight, or pregnant, or if you have a job that requires alot of walking or standing on hard surfaces. You're also at risk if you do a lot of walking orrunning for exercise (overuse injury). And if you have tight calf muscles (which a lot of people have) you're also more likely to develop Plantar Fasciitis.Research has shown, however, that the number 1. cause for Plantar Fasciitis is over-pronation (or fallen arches).Over-pronation of the feet is very common, at least half of the population has this problem,but most people don't realise they have this condition! Over-pronation simply means thatthe feet and ankles roll inwards too much during walking and that the arches collapse. Withage, most people tend to over-pronate. However, this condition is not uncommon in childrenand teenagers, as well as athletes.When the arch collapses the two outside points of the bow (being the heel and ball of thefoot) are being placed farther away from each other. This puts repetitive stress on thePlantar Fascia. The attachment of the fascia into the heel bone is a tiny area of tissue,compared to the wide attachment area to the toes. Therefore, the constant excess pulling onthe fascia will do damage to the weakest attachment point.Over time irritation occurs at the heel bone, followed by inflammation and micro-tearing of the plantar fascia tissue. Sometimes swelling is present. If the pulling continues the heelbone will 'respond' and a bony growth will develop on the front of the heel bone. This isreferred to as a 'heel spur'. Interestingly, the heel spur itself doesn't cause any pain, but theinflamed tissue around it does.
Plantar Fasciitis Treatment options:
 Fortunately, most cases of Plantar Fasciitis can be treated effectively at home. Firstly, youneed to refrain from activities that cause pain such as long walks, running, sports andstanding for long periods. Rest allows any swelling, inflammation and/or pain to subside.Applying ice (or a heat pack) to the heel area and using anti-inflammatory pain killers likeAdvil or Nurofen (both contain ibuprofen) will provide immediate pain relief.However, long term, effective treatment of Plantar Fasciitis consists of a simple program of daily stretching exercises, combined with wearing an orthotic to support the arches.Gentle stretching of the Plantar Fascia, the Achilles tendon and the calf muscles will all helpmaking your feet and a lot more flexible, which in turn will help reduce the exessive pullingof the Plantar Fascia. Do the stretches fist thing in the morning and avoid walking barefooton hard floors and tiles. Instead, slip on a pair of shoes with an orthotic inside them. Repeatthe exercises (especially the calf stretches) a few times during the day.You can find the complete Plantar Fasciitis stretching exercise program here. Or talk to yourphysiotherapist or podiatrist about specific exercises. Sometimes practitioners will prescribea night splint, designed to gently stretch the fascia during the night.
 
With the combination of daily exercises and orthotics you will see a major improvementwithin a few weeks. If you are overweight, it is recommended to lose some weight as thiswill reduce the strain on your feet.In cases where the pain persists, or is severe, Plantar Fasciitis can be treated with acortisone-steroid injection into the heel. However, this is only a short term fix and the painwill return within 3 months. A newer treatment for Plantar Fasciitis (instituted prior tosurgery) is electrocorporeal shock wave therapy. In this procedure, an instrumentadministers pulses of energy (shock waves) to your heel to relieve pain.Surgery for Plantar Fasciitis is rarely required, unless all other treatments have failed torelieve the pain. Surgical procedures include removing a portion of the Plantar Fascia.
Plantar Fasciitis and Orthotics:
 Research in America, Europe and Australia has clearly proven that wearing an orthotic insoleis the best way to treat Plantar Fasciitis, especially when combined with daily exercises.However, it must be noted that this treatment regime is mostly effective for people whohave started to notice heel pain recently (i.e. no longer than 6-8 weeks ago)l or for peoplewho only suffer mild Plantar Fasciitis pain.The reason an orthotic works is simple: the cause of Plantar Fasciitis is the constant pullingof the "bowstring" under the foot, because of the lowering of the arches. Orthotics prop thearches back up, thereby reducing the excessive tension on the plantar fascia.With less tension on the plantar fascia, the damage to ligament can be reversed. The tissueis allowed to heal faster and repair the micro-tearing, which has occurred at the heel boneattachment.There are different types of orthotics, including custom-made ones from a Podiatrist.However, not everyone will need a custom-made device. Nowadays, good supportive andinexpensive orthotics are available from retailers and specialty websites. The main factor issupport, more so than cushioning. So don't buy a soft, spongy or gel foot bed, but rather aninsole with a high arch, made of reasonably firm materials.
Tips for preventing Plantar Fasciitis:
 Correcting some of the pre-disposing factors will ensure Plantar Fasciitis doesn't re-occur,for example:
1. maintain a healthy weight:
loose some weight, as this will reduce the physical loadplaced on the Plantar Fascia during walking
2. wear good quality, supportive shoes:
i.e. shoes with a strong heel counter and withgood flexibility in the front of the shoe (that allows the toes to bend back easily andnaturally). A good shoe will help stabilise the heel and ankle joints during walking andrunning.Don't wear completely flat shoes. A raised heel reduces the tension in the plantar fascia.
3. try to avoid walking barefoot
on hard surfaces (including hard sand on the beach)
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