Plantar Fascia Ruptures

What is a Plantar Fascia Rupture?

Plantar Fascia RuptureThe plantar fascia is a thick band of tissue on the bottom of your foot that extends from your heel to your toes.  It provides stability and support to your arch.  A common cause of heel pain known as plantar fasciitis can occur when the fascia becomes inflamed.  The plantar fascia can also traumatically tear or rupture.  This can occur when jumping or falling from a height or during activities like running or basketball.  If you suffer from a plantar fascia rupture, you may hear or feel a “pop” in your arch.  You will also likely experience sharp pain with bruising and swelling in your arch and heel.

A torn plantar fascia is very painful and requires proper treatment.  Diagnosis of a plantar fascia rupture is made by a complete history and exam.  X-rays and occasionally an MRI may also be necessary.

Treatment and Recovery from a Plantar Fascia Rupture

Treatment for a torn plantar fascia begins with a period of immobilization and crutches followed by a walking boot.  Physical therapy will be initiated, and a supportive, custom orthotic will be made to decrease tension on the fascia.  Recovery can take 9-12 weeks.  Surgery is typically not required, because the fascia tends to heal well on its own.  In fact, a surgical treatment for heel pain caused by plantar fasciitis involves cutting and lengthening the tight fascia.

A ruptured plantar fascia can take several months to completely resolve.  In a 2004 study involving 18 patients with a torn plantar fascia, all patients returned to activities within 4-26 weeks with an average of 9 weeks.  The patients in this study were mostly runners, but this condition can occur in any activity with jumping or running.  If you are suffering from either acute or chronic heel pain, proper diagnosis and treatment of a plantar fascia rupture will ensure a timely return to your activities.

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Facts About Achilles Tendinitis

What is the Achilles Tendon?

Achilles tendinitisThe Achilles tendon is the thickest and strongest tendon in your body.  It runs along the back of your lower leg and inserts onto the heel bone.  When running, the Achilles tendon may endure up to 8 times your body weight.  Because of this stress, the Achilles tendon can be easily injured.  This condition is known as Achilles tendinitis and is a common cause of leg and heel pain in an active individual.

Causes

While there are many factors which may cause Achilles tendinitis such as the lack of flexibility, it is commonly caused by overuse.  This occurs when there is a sudden change in activity level without proper training or conditioning.  If you just ran up and down the hills of Seattle and the back of your heel hurts, you may have Achilles tendinitis.

Symptoms

Achilles tendinitis often begins with swelling and an ache or stiffness in the back of the leg and heel.  If left untreated, the pain can worsen, and in severe cases, the tendon may even rupture.

Treatments

Most cases of Achilles tendinitis can be treated conservatively.  Initial treatments can include rest, ice, gentle stretching, splints, and oral or topical medications.  Physical therapy can provide additional relief.  In some cases, the Achilles tendon may require temporary immobilization with a walking boot.  Surgery may be necessary if the pain worsens despite conservative treatments.

Once the pain resolves, it is important to gradually return to activities to avoid re-aggravating the Achilles tendon.  Proper shoes, orthotics, stretching, and strengthening exercises can help prevent future injuries.

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Top 10 Tips for Preventing Heel Pain

Improper shoes are a major cause of heel pain

High Heels and Heel Pain

  • Make sure your shoes fit and support your feet properly.  If you typically wear very flat, flexible shoes, your heel bone and supporting structures are subjected to increased stress with every step you take.  Over time, this may lead to inflammation and painful heels.
  • Examine your shoes to see if they are still in good condition and are not excessively worn.  After a while, the built-in shock-absorptive capabilities of shoes will diminish.  For those involved in high-impact activities such as running, shoes should be replaced every 300-500 miles.
  • Wear shoes appropriate for your activity.  For example, don’t wear unsupportive shoes when participating in running or jumping activities such as basketball.
  • Minimizing your time spent walking barefoot or wearing  high heels or flimsy shoes.  Wear lower heels or at least vary the heel heights to maintain flexibility.  If you must wear unsupportive shoes for certain occasions, consider using a custom insert to provide cushioning support to your heel and arch.

Training errors can also lead to painful, over-use injuries of the heel

  • Train properly.  When beginning an activity, especially a new one, be sure to stretch appropriately.  Most people have some degree of tightness in their legs so daily stretching is always a good idea.
  • If your leg muscles are weak, you are more prone to developing pain in the back of your heel.  Begin with gradual strength training of your leg muscles.
  • It is also important to give your muscles and tendons enough time to rest and recover between activities.  Refuel your body with healthy food and plenty of fluids.

The structure of your feet may increase your risk of developing heel pain

  • If your feet are flat and roll in excessively (pronate), you will likely benefit from a custom orthotic with a motion control shoe.
  • If you have a high arch and tend to roll out (supinate), you will also benefit from a custom orthotic but with a shoe that provides more cushioning and shock-absorption.

Finally, if weight is an issue, try to lose weight gradually

 

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