WHAT DOES PLANTAR FASCITIS CONSIST OF?
The plantar fascia is a band of elastic tissue that runs from the calcaneus (the heel) to the metatarsal area (under the toes). The inflammation of this structure, mainly in the area where the fascia inserts with the calcaneus, is what we know as plantar fasciitis.
The plantar fascia has a great biomechanical function when walking. It is responsible, along with other structures of the foot, for:
Maintain the plantar arch.
Absorb and return the energy produced when the foot hits the ground.
Protect the metatarsals, avoiding excessive dorsiflexion of the fingers.
IS PLANTAR FASCITIS A COMMON PROBLEM?
Plantar fasciitis, or inflammation of the fascia, is a fairly common pathology in the sports population (runners, athletes, footballers, etc.), although it can also appear after 45 years in people who do not practice sports.
SOME STUDIES AFFIRM THAT AROUND 10% OF THE POPULATION CAN COME TO IT AT SOME TIME IN LIFE.
IS PLANTAR FASCITIS MORE COMMON IN MEN OR WOMEN?
In the non-athlete population it is somewhat more common in women, while in the athlete population the percentage is fairly equal.
In women, there is a direct relationship between plantar fasciitis and the shortening of the posterior leg muscles. The greater the shortening, the more likely it is to generate plantar fasciitis. One of the causes of the most shortening of the posterior chain in a woman is the continued use of high-heeled shoes. For this reason, it is very important, especially for young women, to alternate high-heeled footwear with much flatter shoes to prevent the leg muscles from getting "used" to the height of the heel and shortening it.
On the other hand, in women who have been wearing a high-heeled shoe for many years, the advice will be to try to decrease the height in a very progressive way, but never going from a high heel to a flat one since the increase in tension that will occur in the tendon of Achilles, twins, etc., will exponentially increase the chances of suffering from plantar fasciitis, Achilles tendonitis, low back pain, etc.
In the article "Heeled shoes, do you know everything about this type of footwear?" We analyze the consequences of its use and advise you on it.
WHAT SYMPTOMS CAN MAKE US SUSPECT THAT WE SUFFER PLANTAR FASCITIS?
The main symptom is a sharp pain in the inner area of the heel (it is the area of insertion of the plantar fascia). This pain is usually more intense in the first steps we take when we get up (because the fascia with the rest at night becomes “shorter” and when we take the first steps it pulls with more force). Once we have walked a little, the fascia stretches and the discomfort usually diminishes.
In the case of athletes, in the initial phases of fasciitis, the pain may only appear in the morning and after playing sports. We must bear in mind that when the first symptoms appear we must start taking measures because we have a good chance that fasciitis will worsen and there will come a time when it is very limiting for sports life and even for the normal life of a person having to stand or walk for a long time.
WHAT IS THE DIFFERENCE BETWEEN PLANTAR FASCITIS AND CALCANEOUS SPUR?
Plantar fasciitis is sometimes confused with a heel spur. When in radiological tests we observe a calcification of the postero-internal tubercle of the calcaneus, then we speak of a calcaneal spur (in the radiograph below a kind of "pointed projection" is observed that comes out from the heel towards the inside of the foot). If this calcification does not appear in the tests, we speak of plantar fasciitis.
In reality, the symptoms and treatment are going to be very similar. The spur appears by maintaining a continuous traction of the fascia against the calcaneus. This tension causes plantar fasciitis in the initial phase, and if it is maintained over time, it will possibly generate a calcaneal spur. In both cases, the goal of treatment will be to "loosen" the fascia to reduce inflammation and therefore pain. We could say, although with some nuances, that the spur is the natural continuation of a fasciitis maintained over time.
It is very important to carry out the diagnosis as soon as possible and thus be able to begin to carry out all the actions aimed at "loosening the fascia" as soon as possible. The sooner we start the treatment, the better results we will obtain in the short and medium term.
In the article "Calcaneal spur. Causes, symptoms and treatments" we explain in depth everything you need to know about this pathology.
DOES THE TYPE OF STEP INFLUENCE WHEN YOU ARE MORE LIKELY TO SUFFER PLANTAR FASCITIS?
The way you step is without any doubt one of the main causes of plantar fasciitis.
The types of feet in which we are most often going to find fasciitis are in the cavus feet (bridge higher than normal) and in the valgus feet (feet that tend to collapse inwards). Although they seem totally different feet, in both there is a decrease in the support of the external lateral area, leaving the fascia in a situation of greater tension.
Regarding the way of stepping, it is in those patients who have a greater tendency to pronation (that the foot load tends to move towards the inner side) that we are more likely to find plantar fasciitis.
HOW TO SOLVE PLANTAR FASCITIS?
The biggest difficulty in finally solving this problem is that we often focus more on symptoms than causes. Inflammation, which is the cause of pain, can be treated in many ways, but the important thing is to reduce the tension generated in the plantar fascia.
In many cases, the increased stress generated in the plantar fascia is due to the shape of the foot or the way you step (or both together). If we only treat the acute phase of fasciitis, decreasing the inflammation of the fascia insertion, the patient will improve but possibly will worsen again after some time with their usual physical activity.
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