Plantar Fasciitis: The Achilles Heel of Foot and Ankle Surgeons

Is your heel painful in the morning and intermittently throughout the day? Does your heel hurt when you get up from sitting? Unfortunately, you may have plantar fasciitis.

What is fascia and what is the plantar fascia?

Fascia is tough, fibrous tissue that is all over your body. In the foot, the plantar fascia connects your heel bone to the base of the toes. 

If you’re eating a steak, and you see some white tissue that you can’t chew, that’s fascia. Fascia is annoying in a filet, and even more annoying when it gets inflamed in your body.

What is plantar fasciitis?

Plantar fasciitis is inflammation of the fascia on the base of your heel bone (calcaneus). Patients classically have pain with the first step out of bed in the morning. Also, patients can have pain when they are sitting for a period of time and then stand up. 

Where is pain associated with plantar fasciitis? 

The pain in plantar fasciitis is typically located on the bottom of your heel. Pain in other locations, such as the arch of the foot or the back of the heel (Achilles) could be other injuries, such as Achilles tendonitis.

Who do I see for a diagnosis and treatment of plantar fasciitis?

Orthopedic surgeons can diagnose and treat plantar fasciitis. 

What causes plantar fasciitis?

There are multiple risk factors for plantar fasciitis. In general, it is more common in females. Other risk factors include:

• Obesity
• Prolonged walking or standing
• Tightness of your calf muscle and/or Achilles
• Flatfeet or high arch foot deformities

What happens to the plantar fascia when it becomes inflamed?

During plantar fasciitis, there are microtears in the plantar fascia that generate pain and inflammation. Muscles in the bottom of the foot that bend the toes can also get inflamed. 

Additionally, there’s a nerve branch in the foot that can get irritated by the plantar fascia, causing numbness. Numbness all over the foot may be a sign of another nerve disorder. See your orthopedic surgeon for further discussion. 

Pain is typically mild at the heel. It can go away after activity, but it returns with rest or first step after sitting. 

How is plantar fasciitis diagnosed?

The surgeons at Southwest Orthopedic Group and Dr. Stautberg can evaluate your heel pain to determine if you have plantar fasciitis. 

A thorough physical exam with a patient history can diagnose plantar fasciitis. 

Radiographs can be used to rule out possible bony causes of pain. Occasionally, an EMG (nerve) study is used to rule out tarsal tunnel syndrome (pinched nerve at the ankle).

Will plantar fasciitis show up on an MRI?

Inflamed plantar fascia will show up on an MRI; however, MRIs are rarely needed for the majority of plantar fasciitis. If the diagnosis is not clear, or other injuries need to be ruled out, an MRI may be ordered by your orthopedic surgeon. 

The American Orthopaedic Foot & Ankle Society (AOFAS) has more information about plantar fasciitis FootCareMD.

For more questions or to set up an evaluation, contact Dr. Stautberg’s office at 281-977-4870. 

Author

Eugene Stautberg, MD