Inflammation of the plantar tendon

definition

The Plantar fascia, or also Plantar fascia called, is located on the Sole of the foot and pulls from Calcaneal tuberosity at the Heel bone to the ends of the Metatarsal bones, Metatarsal bone. she is a strong connective tissue plate directly under the skin, which is fundamentally involved in building and maintaining the longitudinal arch of the foot. It prevents the bony arch of the foot from touching the ground under the weight of the body and under load and is therefore exposed to the greatest forces.

Symptoms

Various factors cause the Plantar fascia gets irritated and it eventually leads to inflammation same comes. Especially the Starting point at the Calcaneal tuberosity is affected by the load and inflammation. As a result hurts the Sole of the foot, especially the heel, which is why the inflammation is perceived by those affected.

root cause

The inflammation of the plantar fascia usually has a simple explanation and that is one chronic overload. This overuse of the tendon can in turn have arisen in different ways.
Especially sports, at which much pressure acts on the plantar fascia or the foot is bent or stretched to a great extent are affected. Play here To go biking, Running or ballet a major role.
But also due to occupational stress long standing or exercise a similar stress pattern high train on the plantar fascia. The resulting forces, which on the one hand are very high and on the other hand occur repetitively, are distributed proportionally to the small plantar tendon and the punctual attachment points on the bone. You have to be aware that the heel and exactly the place where the plantar fascia attaches most of the time Load of body weight must wear.

With regular overload, the tissue of the plantar fascia does not have the opportunity to regenerate sufficiently and injuries such as small cracks that can arise during the stress can heal. This irritates the tendon and leads to Development of inflammation.

An irritation can also result wrong footwear which does not adequately support the longitudinal arch of the foot or Bruises on the sole of the foot and thus additionally stresses the plantar fascia. Sometimes the Heel spur, a Bony prominence on the heel bone is one of the causes of inflammation of the plantar tendon. But this arises in the course of inflammation and can aggravate the symptoms or bring them to light, but the Do not cause inflammation.

Diagnosis

The inflammation of the plantar tendon can be diagnosed by just one detailed anamnesis and clinical examination identify. Sufferers usually report pain that increases developed gradually and are below the heel. As a result, the heel is no longer resilient as it was originally, as it is with every step very great pain can cause. The consequence of this is that those affected no sport and depending on the profession, you can no longer do it and report it that way.

At the clinical examination with a suspected inflammation of the plantar fascia is pure outwardly no change recognizable by the sole of the foot and the heel. At the Touch the tendon at the heel, especially at the medial point of the front edge of the Calcaneal tuberosity, but can be a increased sensitivity to pain can be determined on pressure. In some cases one is also whole slight thickening of the plantar fascia can be felt by a edematous swelling can arise as part of the inflammation.

In addition, a simple test can be used to verify inflammation. Here the big toe active be pulled up. This gets under the plantar tendon tension and the attachment point of the tendon on the heel under increased tension, which either already triggers the pain in the heel or the pressure pain can be more easily provoked.

Usually an inflammation of the plantar fascia is clarified X-ray made of the foot. You can say relatively little about the nature of the soft tissue, but you can look at the heel and above all that Calcaneal tuberosity look for hints for a pathological change seen at the transition to the plantar tendon. Sometimes you can find one Heel spurthat has developed in the course of the inflammation and is seen more as an accompanying reaction than as the cause of the overload and inflammation. The existence of a calcaneal spur does not cause any symptoms in some, but intensifies the symptoms of others Plantar fasciitis.
Alternatively, a Bone scintigraphy which, however, is not part of routine diagnostics. An accumulation in the area of ​​the suspected inflammation supports the suspicion.

therapy

When the plantar fascia becomes inflamed, in most cases it is primarily one conservative therapy aimed at. This includes on the one hand insoles for the shoes, which one Recess at the point of the heel spur or the area of ​​origin of the plantar tendon, so that when the foot is loaded, the load is no longer as pronounced at this point as before and this point can recover better.
For another will often Anoint applied locally, the one anti-inflammatory and analgesic effect to have. This can be applied to the inflamed area as needed. In addition, depending on the severity of the pain and inflammation, an appropriate drug can be used together with a Gastric protection prophylaxis given in order to avoid pain peaks in the daily routine and a relieving posture.
In addition, there is also a physical therapy on in the form of a Ultrasound treatment. The aim is through the resulting heat and vibrations in certain frequencies in the tissue The inflammation heals by promoting certain metabolic processes. This treatment can be done in a physiotherapy practice respectively.
Also should targeted stretching exercises the plantar tendon and a Night splint Increase durability, strengthen the tissue and counteract inflammation caused by excessive stress.

If conservative therapy doesn't work, you can go through one surgical intervention think. However, this one comes very rarely used as he not always useful and sometimes there is no real improvement.
If surgery is still indicated, e.g. If the therapy is not successful for more than six months, the following can be done: You can connect Plantar fascia and Calcaneal tuberosity dissolve, but a loss of stability must be expected.
Furthermore, the heel spur can be reduced. However, it is usually not removed as it would not bring any improvement and the plantar tendon could possibly be unnecessarily damaged.
The operation can be both open and endoscopic take place and require follow-up treatment.

prophylaxis

To avoid inflammation of the Plantar tendon Various measures can be taken to prevent this. First of all, it is very helpful if you avoid activities in which the plantar fascia is heavily stressed and tension, or at least not do it too often. If that were the case, then the plantar fascia "to warm up“While stretching. Because there is nothing against physical activity in general that is carried out regularly and correctly, as it improves general well-being. Just specifically that Overload should reduced become.
The best way to do this can be explained by an orthopedic surgeon or physiotherapist and give tips, or you can simply try out what is good for you and what is not. Shoe insoles can also help minimize the load on the plantar tendon and prevent inflammation.

forecast

Even if an inflammation of the planta fascia seems harmless at first glance, it can still cause a high level of suffering in those affected. The reason for this is that the Pain often very much on the heel hold on for a long time and improvement usually only occurs very late or in rare cases does not occur. Thus, every step and every load on the foot are considered unpleasant felt. The treatment the inflammation and the pain is therefore great difficult and not yet entirely satisfactory. Nevertheless, there is hope that the above-mentioned therapy options will bring the pain and inflammation under control.