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  • Sim Chin Seng

Understanding What is Plantar Fasciitis

Understanding What is Plantar Fasciitis ?

Plantar Fasciitis (pronounced as PLAN-tur fas-e-I-tis) is one of the most common causes of heel pain.Plantar Fasciitis involves an inflammation of the Fibrous Tissue (Plantar Fascia).

The Plantar Fascia is a thick fibrous tissue that extends from the Medial Tubercle to the Transverse Ligaments of the Metatarsal Heads in the foot. There are small nerves in and around the Plantar Fascia that are responsible for the detection of noxious stimuli and the proliferation of pain messages.

The usual role of the Plantar Fascia is to provide support to the arch of the foot and help absorb Dynamic Shock. However, when this tissue is overused or overstretched, inflammation could result. This is thought to arise following several microtears that accumulate to cause the symptoms of pain.

Plantar Fasciitis commonly causes stabbing pain that usually occurs with your first steps in the morning. As you get up and move, the pain normally decreases, but it might return after long periods of standing or when you stand up after sitting.

Plantar Fasciitis is more common in runners. People who are overweight and those who wear shoes with inadequate support also have an increased risk of getting Plantar Fasciitis.

What are Some of the Possible Causes of Plantar Fasciitis?

Your Plantar Fascia is in the shape of a bowstring, supporting the arch of your foot and absorbing shock when you walk. If tension and stress on this bowstring becomes too great, small tears may occur in the Fascia. Repeated stretching and tearing can irritate or inflame the Fascia, although the cause remains unclear in many cases of Plantar Fasciitis.

There are several factors that may be associated with Plantar Fasciitis and are thought to be possibly involved in causing this condition, such as:

  • Long periods of time standing up

  • High-impact sports activities

  • Footwear with poor arch support or cushioning

  • Overstretching of the sole of the foot

There appears to be a higher incidence of Plantar Fasciitis in athletes, particularly runners, due to the level of stress placed on the feet during such activities. It is thought that several small injuries that occur to the Plantar Fascia often accumulate and cause the gradual onset of such a condition.

Risk Factors For the Development of Plantar Fasciitis

Even though Plantar Fasciitis can develop without an obvious cause, some factors can increase your risk of developing this condition includes:

(1) Age

While most people assume that athletes are the most at risk for developing heel pain and Plantar Fasciitis, studies show that the biggest risk factor is actually “Age!’.

Plantar Fasciitis is most common between the ages of 40 and 60.

It’s no surprise then, that one of the most common causes of heel pain in older adults and the elderly is Plantar Fasciitis (or Plantar Fasciosis), which happens as a result of wear and tear on the Plantar Fascia (or arch of the foot), degeneration of the heel fat pad, overuse, or inflammation.

Additional risk factors for heel pain that comes with Age include Cardiovascular Problems or Diabetes (which can reduce circulation to the feet), as well as obesity, which places extra strain on the arch of the foot.

(2) Certain Type of Exercises

Activities that placed a lot of stress on your heel and attached tissue — such as long-distance running, ballet dancing and aerobic dance — can contribute towards the onset of Plantar Fasciitis.

(3) Foot Mechanics

Flat feet, a high arch or even an abnormal pattern of walking can affect the way weight is being distributed when you're standing and can put added stress on the Plantar Fascia thus increasing the risk of developing Plantar Fasciitis.

Poor lower Limb Biomechanics, e.g. having ‘Flat Feet’ (over-pronation of the foot) and weak foot arch control muscles, which may reduce the shock absorption, thus affecting the strain on Plantar Fascia. Some have also linked Plantar Fasciitis with the co-existence of a tight Gastrocnemius Muscle (calf muscle).

(4) Overweight and Obesity

Plantar Fasciitis is a major cause of heel pain nationwide, and being Overweight and having Obesity can exacerbate the problem. The added pressure of those ‘extra’ pounds can cause flat feet, placing extra strain on the Plantar Fascia and making walking or standing extremely painful.

It has also been found that overweight or obese patients have a 1.4-fold increase in risk of suffering from Chronic Plantar Fasciitis. On this premise, Pregnancy has also been linked to Plantar Fasciitis, during which additional swelling can relax foot ligaments and alter biomechanics.

(5) Occupations That Keeps You on Your Feet

Certain occupations, including Factory Workers, Teachers, Ballerinas and Warehouse workers, are at an increased risk of developing Plantar Fasciitis because those jobs do not allow you to sit down or rest often, or because they require you to keep walking all day.

(6) Systemic Disease

To reiterate, “Spondyloarthritis” can be prevalent in younger patients with bilateral heel pain. Generally speaking, Arthritic conditions, such as Gout, can cause inflammation in the tendons in the bottom of the feet. What is more, increased thickness of Plantar Fascia in Diabetic Patients has been associated with an increased risk of Plantar Fasciitis.

While the exact connection between Plantar Fasciitis and Diabetes is still not determined, numerous studies show that there is a connection. For example, a 2019 that was study published in the Journal of Diabetes and its Complications looked at the connection between Type I and Type II Diabetes with Plantar Fasciitis. What they discovered was that Hyperglycemia common in Diabetics leads to an increase in Advanced Glycation End Products. This increase in production contributes to increased Plantar Facial Thickness, which in turn increases the risk of Plantar Fasciitis. They found that the rate of Plantar Fasciitis was much higher in those with Diabetes than those without and especially in those with Type II Diabetes.

Another common link between Diabetes and the increased risk of Plantar Fasciitis is the Body Weight. Many people with Diabetes are overweight for their body structure. In fact, studies show that as many as 85 percent of people with Diabetes are overweight. As a major risk factor for Plantar Fasciitis, this additional weight, along with the productions of the Advanced Glycation End Products, puts Diabetics at a much greater risk.

Our nerves are the carriers of pain and other sensations in our body. Although high blood sugar (glucose) levels can cause damage to the nerves throughout the body, it’s the nerves in the legs and feet that are most affected in Diabetic Neuropathy and since the Plantar Fascia is the largest ligament in the human body, it is not surprising that Diabetes affects those longest nerves.

There are basically 4 types of Diabetic Neuropathy:

(1) Peripheral Neuropathy,

(2) Autonomic Neuropathy,

(3) Focal Neuropathies, and

(4) Proximal Neuropathy.

Hence the symptoms vary depending upon the affected nerves which can range from ‘Pain’ and ‘Numbness’ in the Legs and Feet to problems with the Digestive System, Urinary Tract, Blood Vessels and even the Heart.

How Does the Western Medical Practitioners Treat Plantar Fasciitis?

Most of the patients with Plantar Fasciitis report the complete resolution of the symptoms within 12 months of diagnosis with Conservative (Non-Surgical) Treatment Methods.

Allowing the feet to rest and recover is essential to promoting the healing process. In the initial phase, standing up for extended periods of time and walking long distances should be avoided. Instead, keeping the foot elevated as much as possible and applying ice can help to accelerate the recovery time.

Exercises designed to stretch the Calf Muscles (Gastrocnemius Muscles) and the Plantar Fascia can be recommended by the Physiotherapist to improve the strength and stability of these muscles. These should be performed several times each day on a regular basis for the best results. Orthoses can also be worn inside the shoe to provide extra support and to aid in the healing process.

An ice pack can be beneficial to address immediate pain, in addition to simple Analgesic Medicationssuch as Paracetamol or Non-Steroidal Anti-Inflammatory Drugs (NSAIDs).

Less than 10% of the patients will require the use of Surgical Techniques and intervention to address the damage to the Plantar Fascia and improve symptoms. This is reserved as a last-line therapy, due to the potential risks such as damage to the nerves associated with the surgical procedures.

How to Prevent the Onset of Plantar Fasciitis?

There are several tips that can help to prevent damage to the Plantar Fascia, which are particularly useful for people who are at risk of injury to the area. These include:

· Wearing shoes with appropriate arch support and cushioned heels

· Stretching the Plantar Fascia prior to any form of physical activity

· Regularly practicing exercises or stretches to improve stability

Individuals should be aware that spending long periods of time standing or participating in high-impact sports activities are likely to cause them heel problems. If possible, these activities should be avoided. If these activities are necessary or the individual wishes to continue with such activities, appropriate precautions should be taken, such as applying ice following such activities. Additionally, excessive weight can also increase the risk of being affected by Plantar Fasciitis. Therefore, losing your body weight can help to prevent symptoms for individuals who are overweight or obese.

How Can We Help You In FU KANG TCM Wellness?

At the FU KANG TCM Wellness, our TCM Physician, Miss JULI CHEE and our Consultant Therapist. Mr. SIM CHIN SENG worked together to give you a Specialised Form of Treatment which combines a few healing modalities that is unique and not found anywhere else in the other TCM or Western Practitioners clinics. Our treatment is non-invasive and highly effective. Most patients are up and running after just one single session with us. Very rarely do patients need more than one session to resolve their Plantar Fasciitis problems.

Call @ 6983 4964 or WhatsApp to @ 81200830 to book your appointment with our Team to solve your Plantar Fasciitis problems.

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