The plantar fascia is a band of elastic tissue located on the sole, which cushions the impact of walking. Sport, excess weight, or inappropriate footwear can damage it.
To know what plantar fasciitis consists of, we must first know the structure involved in this disorder. There is a thick band of tissue called the plantar fascia, which runs from the heel to the bones of the ball of the foot (where the toes begin). This band’s function is to tighten the base of the foot, maintaining the plantar curvature, and cushion the impact derived from the act of displacement on the sole.
Plantar fasciitis is inflammation of the plantar fascia generally due to overuse (widespread in athletes), stretching it, or the presence of certain predisposing factors. These situations usually generate a series of microtrauma in the tissue that the body does not have time to repair so that they end up causing its degeneration.
It is the most common non-traumatic pain condition in the ankle-foot complex. It is estimated that around 10% of people will suffer from this ailment throughout their lives. It is considered a self-limited problem. That is, 8 out of 10 cases resolve themselves in an approximate period of 10-12 months after the onset of symptoms, despite motivating a good number of medical consultations and generating discomfort that on many occasions prevent a normal life.
For its correction, most of the time, medical and rehabilitative treatment will be reported to, and in rare cases, to surgery, since it is recurrent in up to 30% after the operating room.
Causes of plantar fasciitis
Until recently, it was thought that this problem was associated only with the presence of a heel spur, and although this indeed is one of the causes of plantar fasciitis, it is not the only one. The spur is a bony protrusion formed on one side of the heel bone or calcaneus bone’s ascending curvature. This structure’s presence causes inflammation of the adjacent tissues, including the fascia, and like plantar fasciitis, it causes pain and makes movement difficult.
Plantar fasciitis is usually caused by a gradual and progressive overload of the plantar fascia, and the factors that predispose to its appearance are:
- Excessive foot load is caused by running long distances, especially on unfavorable terrain with steep slopes or uneven surfaces. The use of inappropriate footwear, with the sole too soft or poor support of the plantar arch or heel, can have the same consequences. At the height of running, this is one of the main causes of such a prevalent injury in this population group.
- Flat or excessively arched feet.
- Presence of a tight Achilles tendon (the Achilles tendon is the one that connects the calf muscles to the heel).
- Soleus muscle weakness, which is a muscle located in the calf below the calf. This muscle is in charge of flexing the sole so that if it is altered, the patient will try to correct the fault by modifying its gait and thus causing other types of injuries.
- Age: as we age, the plantar fascia loses elasticity. To this is added that the muscles that participate in the foot’s movement also lose their strength, and their regeneration capacity decreases. The layer of fat present in the heel, which cushions much of the foot’s impact, also decreases, favoring the appearance of lesions in the fascia.