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Getting to the heart and sole of plantar fasciitis

matt kornatz

Historically speaking, the heel has always been a soft spot. If you find you've got a pain occurring in the heel -- whether it's when you’ve gotten up in the morning or after you’re done exercising -- it might be plantar fasciitis.

This week on “Take Care,” Dr. Naven Duggal talks about plantar fasciitis, who it affects and what people can do to ease their discomfort. Duggal is former chief of the Orthopedic Foot and Ankle Service at Beth Israel Deaconess Medical Center and is currently in private practice at Syracuse Orthopedic Surgeons.

Plantar fasciitis is an injury that affects the sole of the foot.

“The fascia is a really thick, tough band that runs from the heel to the base of the toes and that band, at the level of the heel, tends to get excessive amount of strain on it and trauma and it can lead to plantar fasciitis,” Duggal says.

While men and runners are more likely to get plantar fasciitis, 2 million people annually are affected in the U.S. every year.  

“I see it in folks who have a few specific conditions -- for example, a very tight calf muscle,” Duggal says. “We know from the signs that folks who have a tight calf or an Achilles tendon are more prone to developing plantar fasciitis.”

Individuals with high arches or flat feet and those who spend most of the day on their feet are more likely to develop plantar fasciitis. However, according to Duggal, plantar fasciitis is almost always a one-time injury.

“Sometimes it’s something that starts as mild pain in the heel,” Duggal says. “Usually the problem is that patients have this pain and they haven’t really addressed it.”

According to Duggal, more than 90 percent of all heel pain is plantar fasciitis.

“The primary way that we diagnose this is by clinical exams,” Duggal says. “There are other tests that we will use, such as an X-ray.”

Orthopedic surgeons can treat plantar fasciitis and it’s treated by a stretching program which has been designed to address the plantar fascia and the Achilles tendon.

“If patients have a very tight Achilles or calf muscle, those muscles need to be addressed in order to help the heel,” Duggal says.

Not addressing plantar fasciitis can cause further joint pain but, according to Duggal, some of the over-the-counter remedies like gel inserts can work.

“For the patients that have a very high arch or the patient that has a flat foot, then using a pre-made or even a custom orthotic can help,” Duggal says. “For folks who have a normal arch, then using a simple silicone heel cup can often times cushion the heel and decrease the amount of pain.”