For a long time, I had plantar fasciitis. But then things took a turn for the worse and the plantar fascia actually ruptured. I'm going back to see the doc in two weeks. Should I ask for a steroid injection? Would it help things heal faster?
Plantar fasciitis is a painful condition affecting the bottom of the foot. It is a common cause of heel pain and is sometimes called a heel spur. Plantar fasciitis is the correct term to use when there is active inflammation. Plantar fasciosis is more accurate when there is no inflammation but chronic degeneration instead.
Cortisone is an antiinflammatory that can weaken the collagen fibers that make up the plantar fascial ligament and underlying bone. Experts who have conducted studies in this area advise against the use of steroid injections for plantar fasciitis and/or plantar fascia ruptures. The first thing that is usually recommended is activity restriction. If you are a runner or athlete, you will be asked to reduce your activity -- maybe even stop running and jumping.
X-rays are usually taken to see if there has been any additional damage to the calcaneal (heel) bone. Without the protective fibrous sheath of the plantar fascia, load transmitted through the foot is not evenly distributed or transmitted through the calcaneus (heel). Instead, the load on the calcaneus can increase the stress to the breaking point. A calcaneal stress fracture may be the result. Stress fracture means there's a tiny crack in the bone but the bone has not separated.
Treatment is more likely centered around taking weight off the foot using a cast or other immobilizer. When the pain and swelling have gone done, you might be placed in a rigid-sole shoe. A program of muscle strengthening begins when the immobilizer is removed. Regular weight-bearing activities are gradually added in over a period of weeks to months. The length of time this takes depends on how severe the injury was in the first place.
Kenneth John Hunt, MD, and Robert B. Anderson, MD. Heel Pain in the Athlete. In Sports Health. September/October 2009. Vol. 1. No. 5. Pp. 427-434.
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