Plantar Fasciitis

 

PLANTAR FASCIITIS IN CHILDREN AND TEENAGERS
By:  Robert H. Sheinberg, D.P.M., D.A.B.P.S., F.A.C.F.A.S.

 

PROBLEM:

  • An inflammation of the main ligament in the arch where it attaches to the heel bone and supports the foot.  This condition is less common in children and most common in adults.

CAUSES:

  • Excessive activity over a short period of time (i.e. beginning of a sports season at school). 
  • Flat or high arched feet.
  • Tight muscles, especially the calf, hamstrings and external rotators of the hip.
  • Poor shoe gear and walking barefooted.

SYMPTOMS:

  • Pain first thing in the morning when getting out of bed and putting the foot down to the ground.  With walking the pain usually diminishes.
  • Pain after sitting for a prolonged period of time or getting out of a car and starting to walk.
  • Extreme tenderness to touch the heel or arch region.
  • Commonly associated with lower back pain.
  • No swelling, discoloration or heat is ever present. 

TREATMENT:

  • Proper shoe gear to support the arch and heel.
  • Anti-inflammatory medications to reduce the inflammation.
  • Taping the foot to support it and give immediate relief.
  • Custom molded orthotic (shoe insert) to permanently support the foot and prevent reinjury.
  • Frequent stretching of the calf, hamstring and hip muscles to improve overall flexibility.
  • Splinting the foot at night to stretch the muscle in the back of the leg and improve its flexibility.
  • Occasionally immobilization in a cast or a boot to completely rest the foot.
  • Cross training to diminish activity level on the foot (biking, swimming).

PROGNOSIS:

These injuries always go on to complete healing without any long-term problems.