Atypical presentation of a possible Plantar Fasciitis

Patient: A sharp pain has developed on the sole of my right foot after playing some light football. The pain is towards the outside. I have researched about plantar fasciitis, but my symptoms don’t match up. When I even step into a shoe, the pain is unbearable.I can’t walk on my foot. There has been some inflammation, but very slight and with no bruising. I can move all my toes, but I can’t flex my foot upright. Did I sprain my ligament in the arch of my foot? Can it be a fracture? What are some remedies for this?

Doctor: This is not the typical presentation of a plantar fasciitis, but based in your description most likely it is a plantar f asciitis, which is produced by inflammation of the insertion on the heel of the plantar fascia (a fibrous layer that supports the plantar arch muscles and ligaments), causing remarkable heel and sometimes arch pain that alters your normal daily activities.It is the most common cause of heel/foot pain in US. It can be associate or not with a “heel spur”. Initially the pain tends to decrease with walking but gets worse throughout the day as activity increases. The pain worsens by walking barefoot on hard surfaces or walking up stairs.The causes of Plantar Fasciitis are: aging, heel fat pad thinning, too low-arched or too high arched foot, weakness of the calf muscles, leg-length discrepancy, walking or running with inappropriate shoe type on poor cushioned surfaces, a change in the walking or running routine.The suggested strategy is to treat conservatively plantar fasciitis would be: physical therapy aimed to stretch the muscles of the calf and foot, using ice packs after the exercise routine to decrease inflammation and pain, relative rest (avoiding activities that reproduce the pain), use of anti inflammatory meds (example: “Advil”) and replacing of worn-out shoes by adequately cushioned shoes.For cases that do not respond to the conservative treatment, the corticosteroid injection on the site may be considered and if still there is no significant improvement, Surgery might be considered.