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Overuse injury of ligament: Plantar Fasciitis

Q: Why does my foot or arch hurt?

A: It may be plantar fasciitis. The plantar fascia is a very thick band of tissue covering the bones on the bottom of the foot.

The injury occurs from overuse of the ligament and is characterized by:

  • Pain you feel on your first step out of bed in the morning or after you have been at rest for 15 to 20 minutes
  • Sharp pain inside or at the center of the heel
  • Pain that may diminish as you walk but is present throughout the day

Questions to ask yourself include:

  • Have I increased the mileage I run recently?
  • Have I been running at greater intensity recently?

Q: I am not a runner but I think these symptoms describe what I am feeling. What are some other causes?

A: Other sports and even walking can trigger this condition. People who participate in jumping sports like volleyball and basketball also are at risk for such an injury.

Q: So what can I do to prevent plantar fasciitis or to ease the pain?

A: Dr. Hecht advises that you consider the following aspects of your running program:

  • Cut back to some degree.
  • Look into a stretching program. You can speak to a physical therapist or a doctor certified in sports medicine to learn how to correctly stretch your Achilles tendon and plantar fascia.
  • Make sure your running shoes are adequate. Are they well-cushioned? Do they fit properly? You may need an over-the-counter orthotic insert, although sometimes custom orthotics may be necessary. This means you can purchase a full-length replacement insole or try to find someone trained as an orthotist to make one for you. Here at DHMC, call Physical Therapy Services at (603) 650- 5978.

Q: I have tried stretching and cutting back on mileage and intensity of my running program. What now?

A: Almost no one needs surgery for this injury. If you have experienced persistent pain for several weeks after changing your behaviors, seek medical attention. Options at this point may include:

  • A course of physical therapy
  • A night splint or a resting splint
  • In "recalcitrant cases" – when your injury resists conventional treatment – you may require up to four weeks in a walking cast.
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