With the recent injury to Peyton Manning’s foot, ‘Plantar Fasciitis’ has become a popular question from patients of late. This is the first time I have gotten questions from patients about plantar fasciitis who are not afflicted with heel pain themselves. They are asking me to show them diagrams and predict when he will be back. They are simply curious about the condition and have taken an interest since the future Hall of Fame quarterback for the Denver Broncos has been sidelined by an injury to his plantar fascia.
According to media reports, #18 has partially torn his plantar fascia which is a significantly different injury than ‘plantar fasciitis’. This injury can be serious and difficult for an athlete to recover (quickly) from. Antonio Gates, of the San Diego Chargers, another future Hall of Fame NFL player struggled for two seasons with this same injury. One reason he struggled is because he tried to come back too quickly. The physical demands on a tight end vs a quarterback are different, nonetheless, the injury can be a frustrating one for athlete’s to endure.
Plantar fasciitis is one of the most common problems that the physicians at Table Mountain Foot & Ankle treat. We see this condition on a daily basis in all ages,sizes and shapes of patients with the exception of children. Children under the age of 17 simply do not get plantar fasciitis. They may get heel pain but it is for entirely different reasons. It is still quite frequent a parent will bring a child into the office and say “my child has plantar fasciitis”, this is not the case. Plantar fasciitis is an inflammation of the plantar fascia and can be acute (recently developed) or chronic or anywhere in between. Most often we see patients afflicted with heel pain caused by plantar fasciitis for 1-6 mos. However, we also see many patients affected with the condition for many years on their first visit into the clinic. More accurately, when foot specialists speak to one another on the topic it is referred to as “plantar fasiosis”. However, for this discussion/blog we will stick to plantar fasciitis. Plantar fasciitis, if present for a long enough time period can cause thickening of the plantar fascia which can lead to chronic symptoms. Occasionally, a patient may suffer a tear (most often partially) of the plantar fascia. This injury usually requires a longer period of time to heal but typically doesn’t involve surgery. Most often the tear occurs in a patient who was already experiencing heel pain and further injured or strained it, resulting in a tear. However, sometimes a person may tear their plantar fascia in a sudden or abrupt move or stress to the foot. This might occur in a variety of sports. Lastly, the plantar fascia may also tear from the use of steroid injections into the area. This is rare but can happen especially if a patient is too active or engages in strenuous activity within just a few days after an injection of steroid (i.e.:cortisone) to the area. More often this happens when multiple injections are given to the same area in too short a time frame. A tear of the plantar fascia usually is diagnosed with an MRI. Sometimes, a musculoskeletal ultrasound may also indicate a tear is present. However, podiatrists usually must rely on their clinical diagnosis skills and determine when an MRI might be necessary. Most of the time it is not and the patient is suffering from ‘plantar fasciitis’. Frequently patients will report a sudden “pop” or “tear-like” feeling in the arch to indicate a tear. The pain can be excruciating and make walking quite difficult for the first 2-3 days after the injury. Descriptions like this from patients clue us into the possibility of a tear. We can also simply feel the fascia on the injured foot and compare it to the opposite non-injured foot. usually there is a significant difference on palpation by the podiatrist.
At Table Mountain Foot & Ankle clinics we are very experienced at treating plantar fasciitis and plantar fascial tears. We have three excellent physicians to diagnose and treat the condition properly. We have common methods to treat plantar fasciitis that are successful very often. When these are not successful we go to the less common methods when necessary. Today, it is common for patients to come in and request certain treatments they have read about on the internet or heard about from friends/family. Most of the time the timing of these requests is inappropriate. At Table Mountain Foot and Ankle we find which treatments a patient has had or not had prior and develop a treatment plan that is appropriate. Sometimes, treatments such as Platelet rich plasma injections, shock wave therapy or surgery are required. However, a large percentage of patients we see at our clinic do not need these treatments. This is not to say we don’t offer them when appropriate, but and our goal at Table Mountain Foot & Ankle is to get your heel pain resolved as fast as possible in the most compassionate and cost effective manner possible.