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Recovery from Plantar Fasciitis

Our previous articles have been focused on describing the symptoms of plantar fasciitis and to provide an overview of the most commonly recommended heel pain treatments. In this post, we take a look at the process of recovery from plantar fasciitis to better understand it from a biological and biomechanical perspective.

Cure for Plantar Fasciitis

There is only one scientifically proven cure for plantar fasciitis. Unfortunately that cure is time, and lots of it. One study drew this conclusion after surveying a large group of plantar fasciitis sufferers, then followed up on subjects after an extended period of time (over 24 months later). Researchers found that over that timeframe, nearly all cases of plantar fasciitis had been resolved, even those cases which went untreated by participants. It is a common premise that the time required for recovery from plantar fasciitis can be shortened by “rest.” However, for effective results, this means “bed rest” – a no-impact rest that completely removes the potential for re-injury.

Since no stress is placed on a healing fascia during “bed rest,” the body has the opportunity to repair the small tears in the fascia. A complete pause in activity can end the inflammation cycle and bring pain relief. This type of passive recovery model has plenty of benefits – it’s drug-free, low-cost, natural and very effective. However, it is also slow (can take weeks) and so limiting as to be unrealistic for most people. Work, family, social and other obligations have us scrambling for more time to DO things, making bed rest appear to be “out of touch” with the demands of modern life.

When you are in pain, managing a single day can seem like an eternity. Pair that with our desire for immediate results, and it becomes pretty clear that few individuals are in a position to be able to just wait out the pain. It is common for cases of plantar fasciitis to continue for months on end. So what can you do if the sharp pain in the bottom of your foot can easily linger for six months to a year, even with current medical treatments (see comparison of plantar fasciitis treatments)?

For those seeking a ‘quick fix’, painful steroid injections can provide some relief by reducing the inflammation and associated pain. Inflammation is the body’s natural response to injury. If you have inflammation, then it safe to assume the underlying tissue has been stressed, damaged or irritated. Unfortunately, injections are not without risks, and they primarily address the symptom of inflammation, not the root cause of the condition. While these treatments bring pain relief, they wear off and typically need to be repeated in a few weeks’ time, usually with a limit of 2-3 total injections. This is certainly one path to feeling better, but if no other treatment is in place to facilitate healing the patient may be extending his recovery time and missing an opportunity to make significant healing progress. The effectiveness of injections can be increased when combined with a support system (we recommend the FasciaDerm Heel Pain Relief System) which provides protection and support to the fascia, especially during the critical recovery process.

The Problem: Continuous Interruption of the Healing Process

The fascia is a tough connective tissue that runs along the bottom of the foot. It is incredibly durable and resilient when healthy. Once damaged, however, the fascia is very vulnerable to re-injury. Under a microscope, the fascia’s physical structure can be described as similar to a collection of bundled fibers (think of a steel cable of rope-like structure). While the structure is intact, stress is distributed throughout the tissue and handled effectively in support of the foot’s anatomy. However, damage to the fascia takes the form of tears in the structure. If nothing is done to limit the stress placed on this damaged tissue, it is common for the fascia to undergo a repetitive cycle of damage and inflammation as activity continues. Even a single step or incident of moderate stress can re-damage newly forming fascia, which is attempting to repair the injured area.

Supporting the Foot

The plantar fascia undergoes tremendous stress during the walking cycle. A peak of stress occurs during the foot contact phase as the arch is flattened by the forces of the body against the ground. This arch flattening is called pronation. Supportive footwear, insoles and arch supports can be helpful in preventing plantar fasciitis by managing stress through this portion of the walking cycle. If your plantar fasciitis was caused by excessive time on your feet, you should invest in supportive footwear. However, don’t expect footwear alone to bring you the fast pain relief you seek. Near 24/7 support of the fascia during recovery from plantar fasciitis is essential to breaking the cycle of damage and inflammation (i.e. this includes the portions of the day when you are not even wearing shoes). FasciaDerm is compatible with orthotics, insoles and all footwear.

Stretching of the calf muscles and weight loss are also helpful preventative measures. However, stretching the plantar fascia during the healing process risks re-damaging newly formed fascia, which can delay recovery from plantar fasciitis. We suggest avoiding any activity which can re-damage new tissue during the early phase of recovery, including fascia stretching or aggressive massage techniques. If you have a night-time splint or stretching device, stop using it now. You can potentially re-introduce it as part of a prevention or maintenance program once your bout of plantar fasciitis is over.

For many (particularly athletes), the maximum and potentially most damaging stress on the fascia occurs during propulsion, or the heel lift phase, of the gait cycle. Insoles, arch supports and heel pads do little to reduce the stress on the fascia during heel lift. Clearly, stress through the full walking cycle needs to be effectively managed to ensure a timely recovery from plantar fasciitis. FasciaDerm is compatible with, and can increase the effectiveness of the support provided by orthotics, insoles, heel pads and footwear. FasciaDerm also provides vital protection to the fascia during the portions of the day when no shoes are being worn. FasciaDerm can be worn for up to 24 hours per day (even during sleep) to provide support and protection through all load bearing hours.

For a timely recovery from plantar fasciitis heel pain to occur, a continuous, uninterrupted condition of low plantar fascia stress must be maintained.

For most people with plantar fasciitis, the telltale symptom of this condition is the pain experienced when taking a step after a long period of rest (or sleep), due to severe inflammation of the fascia. The inflammation is part of the body’s natural response to injury. It is necessary to stop the cycle of continuous tissue damage in order to alleviate inflammation and relieve the pain.

The Origin of the FasciaDerm Heel Pain Relief System

FasciaDerm has been developed from the ground up to provide all-day support to the plantar fascia, in order to create conditions (similar to bed rest) conducive to a rapid recovery from heel pain. It is common for FasciaDerm users to report an immediate feeling of support and significant pain relief within just a few days of use. To achieve lasting heel pain relief, typical use of the product is in the range of 9-18 days*, making FasciaDerm a cost effective solution for plantar fasciitis heel pain. The actual treatment period will vary from patient to patient. We recommend that use of FasciaDerm is continued for a period of 6 days (or more) after the pain has subsided to allow newly formed fascia to strengthen to better resist re-injury. Many active people, including walkers, hikers and travelers use FasciaDerm to protect their fascia during periods of increased activity, as a preventative measure. If you are prone to plantar fasciitis, FasciaDerm is great to keep on hand as it can be used from the moment you first experience pain symptoms.

“This is a GREAT product!!! Product was received without delay. By the end of day two I walking with very slight pain. I was pain-free by the end of day three. I started running again on day 10. I probably could have started running sooner, but I chose to let the healing process continue before I put the foot under stress conditions.”
– Steve M., Houston, TX

*Most users experience significant pain relief in the first 1-4 days. Typical product use duration is 9-18 days, which includes a number of days beyond the point where pain has subsided. Results will vary.

What is Plantar Fasciitis? Understanding Heel Pain

Editor’s Note: This is the first of a series intended to equip you with an enhanced understanding of plantar fasciitis (or morning heel pain) so that you can make informed decisions regarding treatment and recovery.

What is Plantar Fasciitis?

Many people suffer from a painful condition whose name is hard to pronounce, and which for most people, just as difficult to heal from: Plantar Fasciitis (pronounced: Plantar Fa-cee-I-tis). This is a painful condition of the foot often described to feel like an ice pick in the heel during the first few steps in the morning, or after periods of rest. The sharp pain typically lessens after a few minutes or after a few very painful steps. During the active hours of day the pain may decrease to simply an uncomfortable, achy feeling usually described to feel like a bruise or soreness in the heel. While plantar fasciitis may cause pain anywhere along the arch of the foot, it is most commonly experienced in the heel area, and often only affects a single foot.

Understanding Plantar Fasciitis is Key to Your Recovery

What is plantar fasciitis? Typical heel pain locationThe underlying condition is the result of damage to the tough connective tissue (known as the fascia) which runs along the bottom of the foot and serves as a “shock absorber” for normal movement, including weight bearing, walking and running.

The Plantar Fascia

The plantar fascia is the strong connective tissue connecting the ball of the foot to the heel bone. This tissue is widest and strongest near the ball of the foot and it tapers to its thinnest (and weakest) near its attachment to the heel bone.

The plantar fascia works in conjunction with other bones of the arch of the foot, mediating the impact for every step we take. The plantar fascia stretches and rebounds as the foot interacts with the ground – vital for ensuring the proper functioning of the foot – as well as supporting the healthy, overall mechanics of the body.

Plantar Fasciitis Explained

Repetitive or excessive tensile stress in the fascia can lead to small tears in the tissue that cause plantar fasciitis. These small tears result in inflammation, which in turn causes pain. If healthy tissue on the bottom of the foot is damaged (as in plantar fasciitis) the body responds by inflaming the area around the damaged tissue. During periods or rest or sleep the inflammation accumulates, contributing to the excruciating pain experienced during the first few steps in the morning. As one stands or walks for a few minutes, the local inflammation is forced to disseminate back into the surrounding tissue. This typically helps reduce the severity of pain experienced throughout periods of activity, until the next prolonged period of rest. However, pain upon first standing is most often a clear sign of damaged tissue.

The amount of damaging stress placed on the fascia is influenced by age, activity level, degree of flexibility (for example, tightness of calf muscles), body weight, foot structure and the supportiveness of footwear.

diagram-color-pf

Avoiding Plantar Fasciitis

The key to avoiding plantar fasciitis is to manage the stress placed upon the fascia. To a certain extent, this stress can be managed by:

  • maintaining good flexibility, especially in calf muscles
  • managing body weight
  • limiting sudden changes in activity levels
  • always wearing supportive foot wear.

However, plantar fasciitis inflammation, once it occurs, can persist for months, even with conventional treatments and reasonable attempts to manage plantar stress (as listed above). Under most treatment protocols, relief from plantar fasciitis pain has been difficult to achieve. Because feet are continuously in use, re-injury is a very strong possibility unless the patient is immobilized. The reality is that most conventional treatments fail to create the right conditions for a satisfactory recovery.

By providing continuous support to the injured fascia, FasciaDerm’s patented system brings fast heel pain relief, a significant reduction in daily fascia stress and all-day comfort – without requiring bed rest or immobilization.

So, to summarize our introduction to Plantar Fasciitis:

  1. Symptoms – Sharp pain, usually in the heel, and most severe in the morning or after periods of rest. Plantar fasciitis most commonly occurs in a single foot.
  2. Causes – Repetitive or excess stress on the plantar fascia, influenced by age, activity level, flexibility and footwear choices.
  3. Prevention – The risk of developing plantar fasciitis can be minimized by managing weight, avoiding sudden changes in activity levels, maintaining flexibility and wearing supportive foot wear.

Next: Treatments for Plantar Fasciitis

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