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Caitlin Whyte (Host): Plantar fasciitis is a common cause of heel pain in adults and occurs when a thick band of tissue that connects the heel bone to the toes becomes inflamed. Now joining us today to talk about treating and healing plantar fasciitis is Dr. Colin Graney, a Foot and Ankle Surgeon at Upland Hills Health. This is the Inspire Health Podcast from Upland Hills Health. I'm Caitlin Whyte. So, let's start with the basics. What are some signs and symptoms of plantar fasciitis?

Colin Graney, DPM, AACFAS (Guest): Plantar fasciitis is a type of heel pain that typically is rather sharp or stabbing type sensations in the bottom of the heel that usually starts first thing in the morning, but will get better as the day goes on. But that same type of pain can return after periods of rest, such as eating dinner or after certain car rides, even.

Host: Yeah. Can you dig into more of the anatomy of the plantar fascia? Tell us a bit more about our feet, where it is and what's happening.

Dr. Graney: So, the plantar fascia actually is essentially a very broad and strong ligament that is on the bottom of our foot. It starts right at the base of the heel and goes out towards the ball of the foot. This big ligament is essentially responsible for holding up our arch and giving our foot some support while we stand and walk.

Host: Hmm. So, now why does that become inflamed? What are we doing that causes this? And then how are the Achilles and the calf all related?

Dr. Graney: So, a lot of times people who have plantar fasciitis typically also have a very tight calf muscle. Now how these two are correlated, is the heel essentially acts like a fulcrum where the Achilles tendon and the plantar fascia combine and almost become one continuous structure. So, when one is tight, the other is tight. And so, what happens is, as we step down, that tight plantar fascial band will become stretched and get these little micro tears within it. And that's what leads to that chronic inflammation with every step that we take.

Host: So, when it comes to treatment, let's start with some at home self-treatment options. What can we do when we're feeling this?

Dr. Graney: Some of the easiest things, when you first start to feel the symptoms of plantar fasciitis, so that's sharp, stabbing pain, first thing in the morning, is starting with just some simple anti-inflammatory medication. If you are safe enough to take things like ibuprofen or Tylenol or Aleve, you can start with something like that, as well as just looking up some very simple calf stretches. Now lots of people will go on YouTube or something like that, and they will learn how to do what's called a runner's stretch. And that's just a simple way of stretching out the calf muscle. Even a little bit of massage, taking your thumb and essentially digging into the plantar fascia can help to break up some of the inflammation and loosen up some of those tight bands.

Host: And now if that doesn't work, when should I head to a doctor's office and what options would I be presented with there?

Dr. Graney: A lot of times, by the time you come to see someone like me or another physician, that usually means that some of the easier things that you tried just having a quite word or is beginning to affect your daily activities, where the pain is becoming so severe, that you don't want to do the things that you typically enjoy. That's usually when I'd say either talk with your primary care physician or see someone like myself, a Foot and Ankle Specialist. Whenever we start looking at things like those options where you're seeking medical care, a lot of times I'll even start with x-rays just to look to see, are there any little bone spurs? Or are there any things that can kind of mask or seem like plantar fasciitis. You always want to make sure we're treating the right diagnosis. And then some of my mainstays of treatment are sometimes we can consider things like a cortisone injection or a steroid shot to try to break up some of that inflammation and get you feeling better as quickly as possible.

There's also a few things such as different types of braces or even a stronger oral anti-inflammatory medication. And a lot of times I'll even send people to physical therapy, where they can do some nice stretching materials and they can also do some things that we can't do at home or that I can't do in my office, that will help to kind of get us on the right track.

Host: And if even that isn't working, are there surgical options to fix this?

Dr. Graney: There is a surgical option. It is very rare when people do need this, but it is something that if the other options just don't quite work, it's a very simple outpatient procedure that's minimally invasive where essentially it's almost very similar to a carpal tunnel type procedure. And that's how I relate it to my patients. Where I do it, everything through a camera, and what we do is we just release that tight center fascial band. So, that way the pull of that tight band is released. And then there's essentially no more pain.

Host: Is there anything we can do to kind of prevent this specific type of pain from happening?

Dr. Graney: Some of the easiest things to do to prevent this are even just wearing shoes inside. A lot of times, especially as many of us are working from home or not running as many errands, being as active is, like I said, wearing shoes inside. Some of these things just help to support the Arch or give us a little more shock absorption cushion so that the plantar fascia doesn't become inflamed. We can even try buying a pair of over the counter inserts. Those have been shown statistically to help quite a bit as far as not only preventing, but also minimizing the chance of plantar fasciitis coming back once it's been treated.

Host: Well, thank you so much, Dr. Graney for taking time to be with us today and help us with our feet. Learn more about Dr. Graney at uplandhillshealth.org. This is the Inspire Health podcast. I'm your host, Caitlin Whyte. Stay well.