If there is pain under the heel that is substantially worse when getting out of bed in the morning, then almost always its plantar fasciitis. There are a couple of other things that it could be, but 99% of the time it is plantar fasciitis. Plantar fasciitis is an inflammation or degeneration of the long ligament like structure on the bottom of the foot called the plantar fascia. The role of the plantar fascia is to hold up the arch of the foot, so the most common cause of plantar fasciitis is anything that puts strain on the arch of the foot. This include high level of activity or standing on the feet all day; being overweight; having tight calf muscles; and having poor foot function or biomechanics.
Management of plantar fasciitis is two folded – firstly all those issues that caused the problem need to be addressed, the there are many other types of treatments that are needed to help heal the tissue.
The first line treatments of plantar fasciitis are aimed at those risk factors – getting off the feet and reducing activity levels; stretching the calf muscles; losing weight; and foot orthotics to reduce the load in the plantar fascia. Low dye strapping is often used early to also reduce the load in the tissues. Other treatments that can be used are all aimed at helping the tissues heal, but the first line approaches are still needed to reduce the load in the tissues.
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