Don’t Delay Seeing A Specialist At The First Signs Of Plantar Strain
Plantar Fascia Strain Injury
This 20-year-old student suffering from flat feet heard a snapping noise at the bottom of his right foot while playing tennis with questionable shoes. Experiencing severe pain at the time of the injury, he stopped his game and applied ice right away.
Although the patient was able to walk when he came to the office, his painful condition had a noticeable effect on his gait. It was clear that the plantar fascia of this young patient had been put under excessive and repetitive tension for years due to his collapsing flat feet. This is why, during the game, the weakened plantar ligament partially tore and some of the surrounding blood vessels had become disrupted. Bleeding occurred, producing a wide area of bruising along the arch of the injured foot.
What Does the Plantar Fascia Do?
The plantar fascia is the strongest ligament of our body. This is a band of connective tissue made of thousands of collagen fibers that originate at the bottom of the heel bone, extending down to the front of the foot. This ligament is an elastic band that gets stretched whenever we land our foot down on the ground, acting as a shock absorber. The stretched plantar fascia has stored energy to be used when we push our foot against the ground to accelerate our gait, play or jump.
Definition of a Strain
A strain or partial rupture to this very strong structure is quite common, but a complete tear is rare. A plantar fascia or plantar ligament strain might result from one single traumatic incident or may gradually occur over a long period of time where overpronation has overloaded, caused very small tears, and weakened the links between the ligament fibers.
Symptoms of Strain to the Plantar Fascia
Symptoms of a plantar fascia strain include localised tenderness and pain over the plantar fascia, running from the heel to the forefoot under the foot. There may be a sudden sharp pain at the time of injury under the heel or arch of the foot. A nodule or lump may actually be felt along the plantar fascia, which might indicate a partial rupture.
Treatment includes rest, ice, compression, elevation, full-time wear of good supportive shoes and orthotics. Surgical tear reduction may be indicated after a complete rupture, especially if a prompt return to sport is important. Rest is important to allow the injury time to heal. It may be difficult to rest the foot effectively so do not hesitate to use an air boot along with crutches to really take the weight off the fragilized structure. Apply ice as soon as possible every hour for 15 minutes at a time. Ice applications can be spaced and faded out as the acute phase passes (which will be 3-5 days or more depending on the severity of the injury). Foot elevation over the level of the heart is a good preventive measure to reduce swelling for the first 2-3 days.The daily use of a foot and ankle compression sleeve is also very beneficial to reduce swelling.
What a Doctor of Podiatric Medicine Can Offer
A doctor of podiatric medicine has been trained extensively to be proficient in the treatment of foot and ankle sports injuries. Your foot specialist may tape the plantar skin of the affected foot to prevent further overload by repetitive overextension of the weakened fascia. The use of a professional plantar ligament taping technique significantly reduces the load on the fascia, thus aiding the healing process. A serie of 4 laser treatments using three distinct wavelengths will substantially reduce pain, swelling and inflammation while significantly speeding up the healing process.
A graduated rehabilitation program is required with a gradual and progressive increase in strength works, balance, and flexibility, before return to sports or exercise. After the initial acute phase, gentle stretching, performed under the pain threshold, will be beneficial in helping to restore the plantar fascia to its original flexibility and strength. If the injured plantar ligament is allowed to shorten or tighten up then plantar fasciitis may develop as a secondary and co-existing condition.
Calf, Achilles tendon, and plantar ligament stretching exercises are important. If the affected fascia is very tight, then the use of a night splint can be prescribed. A plantar fascia strain injury usually heals well within two to three weeks.