Pediatric plantar fasciitis

What is plantar fasciitis?

Plantar fasciitis can happen when a tendon on the bottom of the foot, called the plantar fascia, sustains a lot of impact. Over time, this repeated trauma causes the tendon to swell and ache.

Plantar fasciitis usually affects athletes who do sports with a lot of jumping or running, such as dancing, long-distance running and basketball.

What are the signs and symptoms of plantar fasciitis?

• Pain at the bottom of the foot near the heel

• Pain with first steps in the morning, which improves with walking or moving

• Pain that worsens throughout the day

• Pain that worsens with physical activity

• Pain while stretching

• Pain that improves after walking or moving

How is plantar fasciitis diagnosed?

At the Andrews Institute, we diagnose plantar fasciitis based on medical history, activity type and level, and a physical exam. During the exam, we will check the foot and ankle for tenderness to identify where it hurts. This helps us identify the cause of pain.

Typically, we do not need to run any tests to diagnose plantar fasciitis. However, At Children's Health, we work to identify whether each injury is related to or caused by another one. That means that if we suspect other related injuries in a nearby part of the body, such as a stress fracture, we might order an X-ray.

What causes plantar fasciitis?

Plantar fasciitis is caused by:

• Extra weight putting pressure on the feet

• High-impact activities, like jumping or running

• High arches, flat feet or other issues impacting the feet

• Improper stretching

• Improper footwear that doesn’t offer enough support or doesn’t fit correctly

• Tight calf muscles

• Overtraining

How is plantar fasciitis treated?

Our team of experts is highly experienced in treating overuse injuries like plantar fasciitis. We will work with you to develop a treatment plan that is custom-built and fits in with existing daily routines.

In most cases, patients with plantar fasciitis recover with at-home treatments, such as:

• Massaging the area with a frozen water bottle or a ball

• Strengthening exercises for the foot, ankle and arches

• Stretching exercises for the plantar fascia, Achilles tendon and calf muscles

• Icing the painful area for 10-15 minutes

• Modifying their shoes with orthotic inserts

• Modifying their activity level and prioritizing rest

• Taking over-the-counter pain relievers, such as ibuprofen or acetaminophen

• Using mobility devices, such as a walking boot or crutches, to avoid moving their foot in unsafe ways or putting too much weight on it while it heals.

In more severe cases, we might recommend physical therapy. Our experienced specialists will offer:

• Exercises to stretch and strengthen not only the plantar fascia, but other supporting tendons and muscles of the foot and ankle

• Gait training activities to ensure patients can walk without putting unnecessary pressure on the plantar fascia

• Massage, dry needling, cupping and other soft tissue treatments

If physical therapy does not work, we might recommend additional treatments, such as:

• Injections. Injecting medication into the tender area can offer temporary pain relief. Our team also uses the latest diagnostic ultrasound technology to help them clearly see the plantar fascia during injections.

• Ultrasonic tissue repair. We insert a needlelike probe into the damaged plantar fascia tissue to help it heal

• Surgery. In the most extreme cases, some patients need surgery to detach the plantar fascia from the heel bone. This treatment is a last resort. We only use it when pain is severe and other treatments haven’t helped.