Plantar Fasciitis

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The plantar fascia is a slim, strong band that runs beneath your foot, forming the arch. It stretches from your heel to your toes.

Plantar fasciitis is when the plantar fascia, a band in your foot, gets inflamed from too much stretching or usage, leading to heel and foot pain. This can affect one or both feet, often happens from standing a lot, and is a typical foot problem for active men aged 40 to 70.

Causes of Plantar Fasciitis

Plantar fasciitis is when the plantar fascia ligament gets strained or irritated. Constant strain might cause small tears in the ligament, causing pain and swelling that makes walking hard.

Strains can result from:

1. Having a very high or low arch in your foot.

2. Being overweight or quickly gaining weight.

3. A stiff Achilles tendon, the link between your calf and heel.

4. Beginning a fresh activity or boosting its difficulty.

5. Poor footwear choices like too soft soles, ill-fitting shoes, or inadequate arch support.

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Symptoms of Plantar Fasciitis

Plantar fasciitis typically causes heel and foot pain and stiffness. This pain is usually worse:

1. When you first get up in the morning.

2. If you walk after long periods of sitting or standing.

3. When going up stairs.

4. Following exercise.

Diagnosis

Your doctor can diagnose plantar fasciitis by discussing your medical history and checking your foot for pain, firmness, or redness on the bottom. They might observe how you stand and walk and look into other factors like high arches.

Your doctor may request foot X-rays to check for a stress fracture (a tiny crack in the bone), or conditions like a heel spur, an excess buildup of calcium on the heel bone.

Treatment for Plantar Fasciitis

Treatment includes simple steps to ease the condition. These steps are: 1. Rest: Begin with rest, which helps lessen pain and protects the ligament from more harm.

2. Ice: Apply ice by rolling your foot over it. Do this for 20 minutes, 3-4 times daily, to decrease swelling.

3. Medications: NSAIDs can be used to ease pain and lessen inflammation.

4. Exercise: Try calf and plantar fascia stretches to alleviate pain.

5. Steroid Injection: An injection may be given in the plantar fascia to lessen pain and swelling.

6. Shoes & Orthotics: Supportive footwear and orthotics can make walking or standing more comfortable.

7. Night Splints: Your doctor may advise wearing night splints to stretch the plantar fascia during sleep.

8. Physical Therapy: Learn stretching exercises, massage techniques, and ice applications.

9. ESWT: Physical therapists might use shockwave impulses to help heal the plantar fascia.

Surgery for Plantar Fasciitis

Surgery is an option if after a year, other treatments haven’t helped. The type of surgery you'll get depends on your specific case.

Gastrocnemius recession surgery lengthens tight calf muscles to reduce strain on the plantar fascia. Your surgeon will make your calf muscle longer, improving ankle movement. It's done with an open cut or through a tiny cut using an endoscope, a camera-equipped tool.

Plantar Fascia Release: Should you retain good ankle movement but still suffer from heel pain, we suggest a partial release surgery. In this, your surgeon will delicately slice a portion of your plantar fascia ligament to lessen the strain. While this operation can be done using an endoscope, the open incision method is simpler and carries a reduced likelihood of harming nerves.

Risks and Complications

Surgery for plantar fasciitis is usually safe, but like all surgeries, risks exist. Possible issues include:

1. Infection.

2. Nerve damage.

3. Persistent pain.

MEET YOUR RECOVERY TEAM

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Kanwal Bhardwaj

PT, M.Sc.PT, CIMT, CMNT

Meet Kanwal Bhardwaj, PT, M.Sc.PT, CIMT, CMNT, the driving force behind Stride Physical Therapy in Freehold, NJ. With over 20 years of dedicated experience in the field, Kanwal brings a wealth of expertise and a passion for holistic healing to his practice. Kanwal's journey began with a Master of Science in Orthopedic Physical Therapy from Quinnipiac University in 2004. Over the years, he honed his skills and gained invaluable insights during 18 years of service in outpatient physical therapy offices. In 2014, fueled by a desire to deepen his understanding of patient care, he pursued a manual therapy certification (CIMT). This transformative experience allowed him to adopt a whole-body perspective, focusing on treating the root cause rather than just the symptoms...


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A Physical Therapist’s Perspective on Chronic Back Pain

July 12, 20243 min read

At Stride Physical Therapy, we see a lot of chronic low back pain and it’s something we know how to handle. Understanding what causes this pain and how you can prevent it is important to us, so we always make sure our patients and their families are well-informed. Remember, having chronic back pain doesn’t mean you have to accept it as a normal part of getting older. You can still experience less pain and enjoy improved mobility, regardless of how long your back has been bothering you. Book an appointment with Stride Physical Therapy to get a personalized consultation. Keep reading to uncover five key insights our physical therapy team has learned about chronic back pain.

1. Most People Will Experience Back Pain at Least Once

Research shows that the majority of people (up to 80%) will have at least one episode of back pain in their lifetime. While not everyone will suffer from long-lasting pain, many cases resolve within a few weeks without special medical care. However, underlying issues like inflexibility or poor body mechanics can persist, increasing the likelihood of recurring pain and injury. Consulting with a physical therapist early can help uncover and address these hidden factors, reducing the risk of conditions like muscle strains, joint misalignments, degenerative disc disease, disc herniation, and nerve impingement.

2. Most Risk Factors for Chronic Back Pain Are Preventable

Many back pain risk factors are preventable. This means reducing your risk of chronic pain and alleviating symptoms is largely within your control. Common preventable risk factors include:

  • Sedentary lifestyle

  • Excessive weight

  • Smoking

  • Poor posture

  • Physically demanding jobs that require frequent sitting, bending, twisting, heavy lifting, or exposure to vibration

  • Stress, anxiety, and depression

At Stride Physical Therapy, we take a holistic approach to treatment, addressing both physical and psychological factors to help you achieve long-term relief.

3. Exercise Often Improves Chronic Back Pain

Moving around with chronic back pain can be challenging, but participating in daily movement is crucial for pain management. Exercise keeps muscles and tissues strong, boosts circulation, reduces chronic inflammation, enhances mood, relieves stress, and helps maintain a healthy body weight. Activities like walking, cycling, and specific exercises to improve tissue healing, strength, flexibility, and endurance are proven effective. A physical therapist can help you develop a safe, effective, and enjoyable exercise program tailored to your needs and goals.

4. Surgery and Long-Term Medications Aren’t Always Necessary

Contrary to popular belief, conditions like herniated discs don’t always require surgery. Invasive procedures like spinal fusions are usually not the first option for chronic back pain. Research indicates that only about half of first-time back surgeries alleviate symptoms, and repeat surgeries have even lower success rates. Surgery also carries risks such as prolonged recovery time and post-operative complications.

Physical therapy is recognized as a first-line treatment for chronic back pain, often reducing the dependency on opioid medications. This makes physical therapy a safer, more cost-effective option.

5. Chronic Back Pain Can Improve Even Without Knowing the Exact Cause

Many cases of back pain are "idiopathic," meaning the exact cause is unknown. Imaging studies like MRIs often don’t correlate with a person’s symptoms. A physical therapist is trained to evaluate, diagnose, and treat spinal conditions. Even if the exact cause is unclear, physical therapy can still provide relief by addressing symptoms and contributing factors like poor posture, decreased hip and shoulder range of motion, and weak core muscles.

Ready to Make Chronic Back Pain a Thing of the Past?

If you're ready to reclaim your active life and start living with less pain, contact Stride Physical Therapy today. Our team is dedicated to helping you achieve long-term relief and improved function.

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