Diagnosing Plantar Fasciitis & How to Prevent It
Plantar fasciitis is an inflammatory condition that affects the plantar fascia ligaments of your feet. The condition can cause moderate-to-severe discomfort and pain in a sufferer’s heels, and some people experience generalized tenderness and pain along the soles of their feet too.
It’s important to bear in mind that many other conditions can mimic the signs of plantar fasciitis. For this reason, never attempt to diagnose the condition yourself. The condition should only be diagnosed by a medical professional, and any further investigation should be conducted based on your doctor’s clinical assessment.
If possible, consult with a practitioner who is experienced in treating plantar fasciitis. Early treatment is essential to reduce the risk of further complications, so if you’re experiencing heel and foot pain, act fast. This condition may feel better after a period of activity, but it will reoccur after a period of rest, so it should never be ignored.
How the Condition is Diagnosed
Plantar fasciitis is generally diagnosed using a patient’s clinical history and a physical examination. Your doctor will ask questions about a history of morning foot stiffness, worsening of pain when you bend your feet upwards, and problems with activities like scaling stairs or standing on your toes.
Where the pain is located is also an important factor in making an accurate diagnosis. Pain from plantar fasciitis tends to be centralized around the inside of the heel where your plantar fascia are attached. Pain can also occur along the arches and soles of your feet. Your doctor may perform physical tests to assess your level of discomfort before diagnosing you with the condition.
Other factors that could lead to diagnosis include:
- Pain that you feel during your first few steps in the morning
- Pain and stiffness that resolve with activity
- Tenderness that worsens throughout the day and peaks at the end of the day
- No evidence of nighttime pain or a sensation of pins and needles. This could indicate that your pain is due to other conditions like neuralgia or tarsal tunnel syndrome.
Clinical Tests for Plantar Fasciitis
If physical tests are not conclusive, a medical professional may conduct clinical tests to diagnose plantar fasciitis. They will carefully examine your spine, legs, and lower extremities, and even your neurological functions to diagnose the source of the pain. They may ask you to recreate the pain by standing on your toes.
Your doctor will also assess your foot structure and any abnormalities therein. They will examine your Achilles tendons for evidence of shortening, as this is often present in cases of plantar fasciitis. Some other tests that may be conducted include the Windlass test, the Heel Squeeze test, and the Tinel’s Sign test.
Preventing Plantar Fasciitis
There are several precautions you can take to prevent the development of plantar fasciitis. They include:
- Losing weight. Carrying excess weight can strain your body, your feet, and your plantar fascia, making you more susceptible to inflammation and pain.
- Wearing proper shoes. Your footwear can play a major role in protecting you from injury. Never wear poor quality shoes when exercising, or footwear that’s not designed for the purpose you’re using it for. Always check your shoes to ensure the cushioning is in optimal condition. If the soles have started to wear, it’s time for a replacement.
- Wearing shoes when walking on hard surfaces. Always wear your practical padded shoes when walking on hard floors, and when running on tarmac or tough outdoor terrain.
- Choosing footwear that suits your feet. If you overpronate, have high arches or flat feet, you need to wear the right shoes. Footwear that offers the correct support for any of these conditions reduces the stress and strain on your feet that can lead to injury.
- Avoiding high impact exercises that could damage your plantar fascia. Activities like running, jumping, and impact sports can strain your feet and lead to the development of plantar fasciitis.
- Opting for low-impact activities. Swimming, water aerobics, cycling, and yoga are all great exercise options that put minimal strain on your plantar fascia.
- Performing regular leg and foot stretches. There are plenty of stretches you can do to keep your feet supple and prevent this painful condition. Stretch before and during exercise and address any existing pain with the right stretches to alleviate it.
- Don’t tuck in your bedsheets. If you sleep under a tightly tucked sheet, you could strain your feet while you sleep, especially if you tend to sleep on your back. Loosen your sheets and blankets so that your feet can remain in a natural upright position overnight.
How to Treat Existing Plantar Fasciitis
Do you already suffer from plantar fasciitis? If you do, medical experts recommend several different treatments for the condition—some simple, and others more complex or requiring the skills of a specialist. The treatments recommended are:
- Anti-inflammatory medication. Non-steroidal anti-inflammatory drugs such as Ibuprofen can help reduce pain and inflammation in your feet. Discuss this option with your doctor to determine a suitable dose for your case.
- Physical therapy and stretches. If rest and medication are not sufficient, your doctor may recommend physical therapy. A trained therapist can teach you the correct stretches to relax and strengthen your muscles and tendons to soothe the condition. They may also recommend contrast baths, massages, or ultrasonography.
- Shock wave therapy. This unique form of therapy uses sound waves to stimulate your plantar fascia. The waves improve the blood flow in your feet and can assist the tissue in its healing process. It will also stun your nerves, thereby alleviating pain.
- Steroid injections. If your plantar fasciitis pain is severe or is unresponsive to medication, you may consider a steroid injection. They will inject the steroid into the most painful part of your fascia, and this should ease the pain and inflammation for around four weeks.
- Surgery. This is a last-resort option that your doctor will only recommend in a very severe case. The operation will remove your plantar fascia from your heel bones. It may require you to wear a boot or a splint for a while, and you will not be able to put weight on your affected feet until they are fully healed.
Plantar fasciitis can put a halt to your training regime or sports career, so the best advice is to address it quickly before it becomes worse. This condition is incredibly common, with around one in ten people suffering from it. Fortunately, it can be treated or managed with the help of a medical professional.
Story by Megan P. Howard.