The plantar fascia is a thick band of tissue that runs along the bottom of the foot, connecting the heel bone to the toes. The plantar fascia is a passive tissue that cannot contract like a muscle, but it plays a vital role in the structural integrity of the foot by supporting the arch of the foot and absorbing shock during activities like walking or running. A plantar fascia tear occurs when this tissue is partially or completely torn, damaged or a ruptured.
What are plantar fascia ruptures?
Plantar fascia ruptures are commonplace among athletes and anyone who participates in high-impact activities that place a lot of repetitive stress on the feet. Also, people with occupations requiring long periods of standing are more susceptible to plantar fascia tears from overuse. When you stand, the foot spreads and stretches the plantar fascia.
What are three common risk factors for plantar fascia tears?
People who are overweight, have flat feet or high arches, have an abnormal gait or structural abnormalities, as well as those who wear improper footwear are at a higher risk of a plantar fascia tear. The tear may also result from sudden trauma or injury to the foot from a fall or from exercises involving jumps. Also, steroid injections that are prescribed for plantar fasciitis can decrease pain levels for the patient but over time, they expose the patient to a possible plantar fascia tear or rupture.
The tear will make a popping sound at the moment of injury and cause acute pain in the bottom of the foot, near the heel and in the arch of the foot accompanied by swelling, redness, bruising and is incredibly tender to the touch. You will be unable to bear your full weight or push off with your foot. A plantar fascia tear can occur in various parts of the fascia, not just in the arch and not everyone suffers a full rupture. Some patients suffer a partial tear, which can worsen if not allowed to fully heal.
How do you diagnose a plantar fascia tear?
If you think you’ve torn your plantar fascia, seek the care of a foot and ankle specialist, a physical therapist or a sports medicine doctor who will know how best to treat it. The first thing the doctor will probably recommend is an MRI or Ultrasound. An ultrasound is a cost-effective method of diagnosing a plantar fascia tear, while an MRI can give a more detailed image. The MRI exam will identify whether the plantar fascia is partially or fully ruptured, or if another area of the foot is causing the pain.
Initially, a severe plantar fascia tear is placed in a walker boot for 2-4 weeks to reduce inflammation and allow the plantar fascia time to heal before starting physical therapy. Once the boot is removed, a gradual increase in walking volume is recommended and physical therapy can begin, consisting of a physical assessment to identify muscular weaknesses, tight tissues and balance deficits, and leading to a thorough rehabilitation protocol. Physical therapy exercises can help strengthen the surrounding muscles and improve flexibility of the affected foot.
How do you treat a plantar tear?
Milder plantar fascia tears can be managed with correct footwear, insoles, and/or taping and a combination of rest, ice, compression, and elevation (the R.I.C.E. method). Immobilizing the foot with a brace or splint may be recommended to promote healing. In more severe cases, non-steroidal anti-inflammatory drugs (NSAIDs) may be prescribed to alleviate pain and reduce inflammation. A plantar fascia tear does not require surgery, but in rare instances where conservative measures fail, surgical intervention may be considered.
Can you walk on a torn plantar fascia?
Depending on the severity of the injury, you’ll need to avoid full weight bearing for days or weeks. If you suffer a full rupture, recovery may involve months before you’re ready to return to intense activities, like the one that caused the fascia to rupture in the first place. A torn plantar fascia usually takes 4-9 weeks to heal.
With proper and timely treatment, many individuals recover from a plantar fascia tear and can resume normal activities. However, the recovery time can vary depending on the severity of the tear and how well the individual adheres to the prescribed treatment plan. It's essential to follow medical advice, including any recommended lifestyle modifications or exercises to optimize the healing process and prevent recurrence.
For more information on common foot problems as well as in depth charts click here.
