Florida Foot Specialists

Ankle Specialist

Heel Pain and Plantar Fasciitis Treatment

Charlie Alexander, a triathlete, came to my South Florida podiatry office for plantar fasciitis treatment after not being able to participate in his favorite pastime for over a year and a half due to constant foot and heel pain.

The final straw was when he could not even get out of bed because of the pain in his heels.

Diagnosed with a severe case of plantar fasciitis, Charlie had unsuccessfully tried all classic symptomatic treatments such as stretching, cortisone injections, anti-inflammatory medications and conventional podiatric orthotics.

However, Charlie had never tried High Performance Full Contact Icon orthotics.

He was very skeptical since he had tried orthotics several times before.

I prescribed a pair of Full Contact Icon orthotics for Charlie and within six months, he was again competing in the Ironman triathalon, pain free.

What Is Plantar Fasciitis?

Plantar fasciitis is one of the most common causes of heel pain. It often occurs without any history of trauma.

Patients experience a lot of pain especially when they get out of bed first thing in the morning or after sitting for long periods of time and then standing up.

It is especially common in runners, people who are overweight, pregnant women, and those who wear shoes without adequate support.

instructional photo of a foot diagram with parts of the foot labeled.

The plantar fascia is the thick band on the bottom of the foot that attaches to the heel and extends to the toes.

Without this band, the foot would totally collapse each time you stepped on it.

Plantar fasciitis is thought to be an irritation to the plantar fascia or the plantar fascia pulling away from the bone on the inside of the heel. Over time a heel spur appears on x-ray.

There are many common treatments for this problem, which include…

  • stretching
  • night splints
  • motion control shoes
  • physical therapy
  • anti-inflammatory medicines

Patients come into our office for plantar fasciitis treatment after being treated for months with some or all of these treatment methods listed above.

The reason that these modalities do not help is the fact that they are addressing the patient’s symptoms and not the underlying problem.

The underlying problem is the pulling away of the plantar fascia from the heel bone. During the day, the band partially detaches from the medial side, or inside, of the heel. At night, the foot relaxes and the band starts to heal back to the bone.

With only 6 to 8 hours of healing time, when the patient steps down in the morning, the band pulls away from the heel, causing the pain that occurs when first arising.

Conclusion

In summary, plantar fasciitis is due to biomechanical abnormalities, or a breakdown in the structure of the foot.

Poorly functioning feet can also lead to knee, hip, and lower back pain.

Biomechanical issues must be addressed for the long-term resolution of this problem.

The use of High Performance Full Contact orthotics, specifically the ICON ORTHOTIC, allows the plantar fascia to stay in contact with the heel bone while weight bearing. This is the single most important long-term treatment.

If you can keep the plantar fascia close to the bone while standing, it is kept close to the bone when off weight-bearing, and that leaves only the first 30 to 60 minutes every morning when a patient showers and then gets dressed, when the band is pulling away from the heel.

This allows the body a significant time advantage to heel the problem by itself.

If you allow the body to heal the problem by itself, it will.

When treating this problem, I explain to my patients that if we can address the underlying causes, we rarely have to treat the symptoms.

I treat less than 5% of my patients with cortisone injections or any of the standard symptomatic treatments.