This article talks about the foot medicine which is constantly evolving with new techniques, tips, treatment methods, injury prevention etc. Today we're talking about a common foot health issue of so called plantar fasciitis, a problem that is quite prevalent in runners, but also people with a more sedentary lifestyle, especially men in the over fifties age group. This common injury can be located at the junction of the heel bone and the plantar fascia. It is actually an inflammation of the membrane or fascia overlying the muscles of the foot and its insertional area at the calcaneus. In long distance runners pain in the foot is more often due to inflammation of the plantar fascial band, caused by repeated and significant traction with impact, followed by propulsion through the forefoot. The function of the fascia is to provide our longitudinal arch of the foot, plus to provide stability and shock absorption during running and walking.

The causes of this typical foot injury are varied, for example: Inadequate training, overload, anatomical variations in the feet, over-pronation, fallen arches or a cavus foot. Also short Achilles tendon, people who have limited ankle flexion, the wrong shoes (sole too rigid or too soft, excessive wear of the heel), running on the balls of your feet, the falls can favor fasciitis, especially in athletes with lower limb biomechanical imbalances that make us bad support, the difference in length (dysmetria ) of the lower extremities warm curved hips and eversion. Possibly the most common problem we treat is plantar fasciitis, often referred to as a heel spur. Starting as a dull intermittent pain in the heel it may progress to a sharp persistent pain which spreads forwards into the arch. It is generally worse in the morning with the first few steps, or after sitting for a period of time and then standing up. The pain normally goes away when you start walking but recurs after a period of rest, which is often why if left untreated plantar fasciitis develops to severe pain that can stop you from weight bearing on your heel. Plantar fasciitis occurs when the heel is submitted to repeated stress, especially when running on land or hard surfaces, because they produce a continuous pounding on it, leading to what is medically called micro-trauma, which causes inflammation in the heel and then leads to pain. In cases of chronic heel pain, if there are those who seek the so-called heel spur (peak in the bottom of the heel can be seen on the radiograph), which causes inflammation around the fibers of the fascia, although athletes do not have because the cause of the fasciitis. In addition 15-25% of the population without symptoms have heel spurs, and many fasciitis runners do not. While it is a common condition, not all heel pain is plantar fasciitis. Heel pain syndrome, resulting from repetitive pressure placed on the heel of the foot when walking, causes soreness of the natural cushion that supports the heel of the foot, the bursa. Known as bursitis, it is often associated with plantar fasciitis, and both can be treated together.

The pain is quite clear when we touch the heel in front and follow the path of the fascia, on the sole to the toes. When you start running, as in other sports injuries due to overload, it can trigger the pain especially at the beginning of a workout. May decrease during the race, not reappearing until the end of it, sometimes several hours later or the end of the day. As we do not stop training, we fall into a vicious circle, where each train further aggravated the injury, coming in more severe cases to be incapable of daily activity. X-rays will only see if there is a growth in the calcaneus (heel) called heel spur, which appears occasionally, although their presence or absence is not helpful for the diagnosis of plantar fasciitis. And other evidence will only be used when it is not clear that it is plantar fasciitis. Footwear criteria. Adequate footwwear should be: comfortable to wear; fitted to the appropriate size (width and length of the foot); it's a good idea to buy new shoes at the end of the day, rather than in the morning; shoes should feature good cushioning and have a stabilising heel counter and flexible forefoot area. In specialty shoe stores you will get the right advice for the correct choice of the shoe and shoe fitting is done professionally. While there is no evidence of the effectiveness of a particular treatment for plantar fasciitis, we do have a few recommendations which can prove very useful.

To heal quicker and without relapse, identify the injury as soon as possible and avoid any more running or long distance walking. With the onset of pain, apply some ice and rest as well, allowing the foot tissue to heal and the micro-tearing to repair itself. If self-treatment fails, some form of surgery may be required. The American College of Foot and Ankle surgery, recommends surgery if pain persists after 3 months of treatment without success. Calcaneal Epiphysitis is heel pain in adolescents. Continuation of this irritation can lead to heel pain, arch pain or a bony growth on the bottom of the calcaneus, referred to as a heel spur. Heel pain syndrome is also referred to as bursitis. Orthotic therapy is one of the most effective forms of treatment for condition, because foot orthoses address the underlying biomechanical cause of the condition and allow the foot to heal much faster, by reducing strain on the injured ligament.