When the first step in the morning hurts
Plantar fasciitis
What is that?
Plantar fasciitis is a painful inflammation on the sole of the foot. The inflamed plantar fascia originates from the heel bone and runs in a fan shape to the tip of the foot. A fascia is a tendon that gives the foot stability, but also mobility at the same time. Long-term inflammation can become chronic, and additional calcium deposits can cause further pain.
How does this manifest itself?
The pain is often localized on the inside of the sole or heel. The pain is usually stabbing or pressing. The symptoms occur more frequently in the morning after getting up or after longer periods of rest, because the plantar tendon shortens during rest periods. If the foot is now put under strain, the fascia is stretched by several centimeters in milliseconds, which leads to pain at the inflamed attachment point.
After a few steps, the fascia has stretched and the pain usually decreases. However, after walking for a longer period of time, the pain usually gets worse again.
Where does it come from?
Common causes of this type of problem are foot deformities such as crooked, fallen arches or flat feet, but also hollow feet, where the plantar fascia is already anatomically shortened due to the shape of the foot. Overloading of the tendon due to incorrect footwear and the natural wear and tear of the tendon due to age can contribute to this, as can excessive body weight.
Genetic factors can also play an important role; people with thyroid diseases, diabetes, or gout, for example, tend to develop inflammation in the body more easily.
What happens if I don’t act here?
Inflammation of the plantar fascia should be treated as soon as possible after the first symptoms appear, as the inflammation can become chronic and, in the worst case, the fascia can rupture (tear). In the case of a rupture, treatment would be much more lengthy and would usually require several weeks of rest. A complete rupture can also lead to surgery.
If the heel hurts, you automatically adopt a relieving posture, which in turn leads to problems in other joints.
How do I find out if I have something like this?
Diagnosis usually only involves taking a pain history and carrying out various clinical tests. An ultrasound or MRI can also be useful to rule out other diseases. An X-ray does not always show a bony heel spur (calcification directly on the heel), which can form at the attachment point due to incorrect loading.
The MRI scan can assess the structure of the fascia, and the doctor can see whether there is merely inflammation in the tendon or bone, or whether the tendon has already torn.
How do you treat this?
The most common treatment method is to reduce the load. The most important thing here is to redistribute the pressure on the heel. Cushioning materials should be used in the heel area. Gel pads or a "buffer heel" applied to the shoe are helpful here.
The more elegant solution is to fit an insole, which ideally consists of different layers and, in addition to its cushioning effect, also relieves pressure on other areas of the foot.
Insoles can address the different locations of heel pain, either by exposing and padding the pain point, padding the heel area, or exposing the fascia if the pain radiates to the front area of the foot.
In acute pain, shock wave therapy or rolling over a water bottle from the freezer can provide relief. Stretching exercises for the calf and foot fascia, preferably with foot rollers or balls, are also recommended.