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Plantar Fasciitis (Heel Spurs)

What is Plantar Fasciitis?

Plantar Fasciitis (pronounced PLAN-tar fashee-EYE-tiss) is an inflammation of the plantar fascia. "Plantar" means the bottom of the foot, "fascia" is a type of connective tissue, and "itis" means "inflammation". Heel spurs are soft, bendable deposits of calcium that are the result of tension and inflammation in the plantar fascia attachment to the heel. Heel spurs do not cause pain. They are only evidence (not proof) that a patient may have plantar fasciitis.

The plantar fascia encapsulates muscles in the sole of the foot. It supports the arch of the foot by acting as a bowstring to connect the ball of the foot to the heel. When walking and at the moment the heel of the trailing leg begins to lift off the ground, the plantar fascia endures tension that is approximately two times body weight. This moment of maximum tension is increased and "sharpened" (it increases suddenly) if there is lack of flexibility in the calf muscles. A percentage increase in body weight causes the same percentage increase in tension in the fascia.

Due to the repetitive nature of walking, plantar fasciitis may be a repetitive stress disorder (RSD) similar to tennis elbow. Both conditions benefit greatly from rest, ice, and stretching. Surgery is a last resort and may result in more harm than good in up to 50% of the patients.

What are the symptoms of Plantar Fasciitis?

These are some of the common indicators that you may have Plantar Fasciitis:

  • Do you suffer from heel pain?
  • Does it feel line you have a nail in your heel?
  • After walking for a few minutes does the pain slowly disappear?

The pain came on slowly for Jim, a 53-year-old who has been running for 22 years. "At first, it seemed like just another pain in the foot, then like a bruised heel," he recalls. "It hurt in the morning on the first step getting out of bed. It hurt when I walked in my street shoes during the day. After two months of trying to run through the pain, I stopped running."

But it was different for Bridget. "The pain started suddenly, at the bottom of my left foot," says Bridget, a 40-year-old stay at home mother. "The pain moved and was never so bad that I couldn't run, but I was afraid I'd do serious harm if I continued to train through the pain."

For Andy, a 38 year old, the pain "would start in the foot and shoot up my leg with each step. I couldn't find any step that wasn't painful."

Millions of people each year are faced with this type of pain. While there may be other causes, the most common is Plantar Fasciitis.

Plantar fasciitis is the most common cause of heel pain ther is. Many patients with plantar fasciitis have a heel spur on the front and bottom of their heel, but heel spurs do not cause pain. The common name is "heel spur" because it's easier to pronounce than "plantar fasciitis" and doctors are able to point to the spur on an x-ray. Causes of heel pain include poor flexibility in the calf muscles, lack of arch support, being overweight, suddenly increasing activity, and spending too much time on the feet.

What causes Plantar Fasciitis?

A flattening or overstretching of your plantar fascia can cause microscopic tears, inflammation, and a burning sensation. While developing slowly, there may be a sudden severe event sometimes occurring in only one foot at a time. Plantar Fasciitis can affect people of all ages and backgrounds. Some contributing factors include age, weight-bearing activities, sudden increase in physical activity, improper shoes, excess weight or a recent weight gain (as little as 5 pounds), and poor biomechanics (flat feet, high arches or unnatural gait). Until now the treatment methods have addressed the active conscious periods only to be undone when a person goes to bed or sits in the easy chair relaxing.

Treatment Options

The Strassburg SockTM is a device that consists of a tubular knit material that fits "over the calf" with 2 attached adjustable straps to maintain the foot in a neutral to slightly stretched position. When worn at night the device will apply a force which results in the reduction and/or elimination of the pain felt during those first steps in the morning.

How does the "Strassburg Sock" work?

This easy to use, inexpensive device is designed to keep tension on the tissue (plantar fascia) so it heals in a stretched position at night. In this way many users find a reduction of their morning pain, some have noticed a reduced recovery time and yet others have reduced the need for medications.

When worn as prescribed, it does not allow the plantar fascia to contract while in the prone or supine position. The device holds the ankle and forefoot joints in a position of slight dorsiflexion that prevents a position of plantarflexion, that is the plantar fascia is not allowed to contract.

In addition the involuntary stretching of the plantar fascia over a long period of time helps to strengthen the foot's arch.

Research Studies

An independent research study using the Strassburg SockTM as the exclusive night splint was published in the July/August 2002 issue of the Journal of Foot and Ankle Surgery. The hypothesis of the study was this. When other injuries occur, standard medical practice is to place and maintain the damaged tissue in an anatomically correct position for the duration of the healing period. If the proper position is not maintained, then swelling, muscular contracture, pain, and delayed healing are seen. The same concept can be extrapolated to plantar fasciitis. Treatments for plantar fasciitis should be focused toward addressing the abnormal pronation and placing the damaged ligament at anatomic length, without uncontrolled stretching.

This study, the second largest ever to evaluate the effectiveness of a night splint consisted of 160 patients. 89 patients used the Strassburg SockTM and 71 were prescribed a gastrocnemius-soleus stretching regimen. Patients using the Strassburg SockTM were told not to stretch during this treatment period, but were instructed to wear the sock for at least 6 hours at night. The results of the study were as follows:

  • the mean recovery time for patients using the Strassburg Sock was 18.5 days
  • 97.8% recovered within 8 weeks
  • all 89 patients were able to wear the Strassburg Sock as prescribed (We believe this to be an important fact because in several other studies a significant number of patients did not complete the treatment due to the night splint being uncomfortable)

All patients in the study were at least a 7 on a 10 visual analogue scale for painful plantar fasciitis.

The Strassburg Sock TM is designed as a supplemental treatment for heel pain from Plantar Fasciitis. Its purpose is to provide an involuntary nightly assistance to your established daily treatment.

The Strassburg Sock is now available at The Maher Sports and Wellness Centre.

Phone (706) 864-1480 to order.

Click here to request more information on how The Strassburg Sock can help you.

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Phone (706) 864-1480

The Strassburg SockTM is a supplemental treatment for heel pain caused by Plantar Fasciitis.
It provides involuntary assistance to your established daily treatment.

The Strassburg Sock is now available at The Maher Sports and Wellness Centre.

Phone (706) 864-1480 to order.

Get Patient Forms and other Patient Information here