Since I was 14, I have had plantar fasciitis. I did not know I had it until a pediatrician told me a year later.
The year before I ran in a marathon through the downtown capital of Georgia. In gym class, I ran for twenty minutes with no significant pain afterwards. A year after my diagnosis, I have walked for long distances and a long time like 10 miles and about 10 hours. All the while, I never felt any severe pain except some moderate burning and a little swelling in my foot. And I did not wear the most supportive shoes.
I have never felt pain at my heel, but above it where the arch begins and beneath the ball my foot. The burning would always subside after walking or running for long periods of time. When my foot burned or swelled I iced and rested it later. As soon as the pain went away for a while I got back to my usual exercises, walking, running, or playing sports.
I have not had physical therapy and any home remedies such as stretching, wearing orthotics, and icing I have done, but not consistently. Only until the pain subsided.
Is it too late to go to physical therapy? Is it too late for me to recover from plantar fasciitis because of all the stress I put it through?
Dr. Nirenberg’s reply:
Plantar fasciitis is one of the most common problems I see, and the number one cause of heel pain. Plantar fasciitis occurs with the ligament on the bottom of our heel and foot—the plantar fascia—becomes enflamed.
The plantar fascia becomes irritated when the biomechanics of the foot malfunction and foot pronates excessively. All feet pronate, which is a complex motion that involves the heel turning outward during ambulation. Often, feet that pronate will have a low arch, but pronation can occur on occasion in persons with a normal or even high arch.
This malfunctioning foot biomechanics can cause a host of problems, including the plantar fascia to want to pull away from your heel bone or even tear (yank a handful of hair from your scalp and you will begin to understand the pain of the plantar fascia pulling away from the heel bone).
Plantar fasciitis can also cause pain in the arch of the foot. However, the fact that you relate burning, makes me suspicious that you have plantar fasciitis. I don’t want to doubt your pediatrician’s medical exam, but it sounds like you may have tarsal tunnel syndrome.
Tarsal Tunnel Syndrome
Almost everyone has heard of carpal tunnel syndrome in our hands, but few people realize the same problem occurs in our feet. Tarsal tunnel syndrome may cause burning, tingling, shooting pain, or a cramping sensation in our foot, particularly in the arch and the ball of the foot. Some people will fell like the ball of the foot or arch is swollen.
The good news is that there is a light at the end of this tunnel. Tarsal tunnel syndrome is often easily treated with orthotics, injections, or a short, outpatient procedure.
Both tarsal tunnel syndrome and plantar fasciitis respond to orthotics and physical therapy, and so I would recommend these as a first step.
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