Author: Phil Ghuneim – Workers’ Compensation Coordinator/ Corporate Communication Manager

In Honor of Dr. Svetlana Zats joining the MidAmerica team, let’s take a look at one of the most common conditions that a Foot and Ankle Specialist, like herself, is able to treat.

Plantar Fasciitis

Colloquially known as ‘Policeman’s Heel,’ plantar fasciitis refers to an inflammation of the thick tissues extending from your heel to your toes. These tissues, known as the plantar fascia, play a crucial role in supporting the arc and extension of the foot. If the condition becomes chronic, fibers of the plantar fascia can start to degenerate. This can lead to partial or complete plantar fascia ruptures.

Risk Factors

While the causes of plantar fasciitis aren’t entirely clear, some risk factors that are associated with the condition, include:

1. Prolonged standing - Standing or walking for extended periods can put unnecessary strain on the plantar fascia.
2. Obesity – For obvious reasons, being overweight puts extra pressure on the heel and requires more support from the plantar fascia. The paradox is that, people who are overweight are more likely to have heel pain, but their heel pain keeps them from exercising.
3. Excessive exercise – Each step that you take causes your plantar fascia to expand and contract. Running a mile would force this tissue to expand and contract thousands of times. If you don’t give the tissue sufficient time to rest and recover, it can lead to significant strain and irritation.
4. Not enough exercise - Conversely, keeping the foot inactive for prolonged periods of time can cause the plantar fascia to lose its flexibility. Moderate amounts of exercise can help to keep the tissues limber and strong.
5. Other risk factors include: Tight Achilles/Achilles tendonitis, high arches of the feet and flat feet.

Symptoms/Diagnosis

When diagnosing plantar fasciitis, Dr. Zats will typically look for tenderness or pain in the bottom of your foot. Specifically, irritation and tightness of the heel bone and/or the Achilles tendon. Dr. Zats will also consider the aforementioned risk factors as well as the patient’s presenting history. Another symptom that Dr. Zats looks for is limited dorsiflexion (backward bending/extension) of the foot which can be caused by tightness of the calf muscles or the Achilles tendon.

In rare cases when plantar fasciitis is not apparent, physicians may use imaging such as x-rays to ensure that the diagnosis is definitive.

Treatment

In a study in Swiss Medical Weekly conducted on recalcitrant plantar fasciitis, the researchers found that “up to 90% of patients with PF (plantar fasciitis) will be cured within 6 months with conservative treatment.”(Zhiyun et al., 2013) This conservative treatment may include nonsteroidal anti-inflammatory drugs such as aspirin, physical therapy, and/or shockwave therapy.

Other conservative treatment measures include corticosteroid injections, which can provide short-term pain relief, and platelet-rich plasma (PRP) injections. Platelets, which are a component in blood, contain proteins that can help to subdue inflammation. As a rare last resort, a plantar fasciotomy may be considered if conservative treatment fails to resolve the issue after 6 months.

Dr. Zats will be serving patients in the surrounding areas of our Palos Hills and Mokena locations starting June 4, 2018. To learn more about Dr. Zats, click here! To schedule an appointment with Dr. Zats, please call (708) 237-7200.