If you are reading this with your shoes off, place a couple of fingers at the bottom of your foot in the center at the arch. While doing so, extend your toes upward, your whole foot now like a cat stretching. Feel that band of fibers nudging out at the bottom? Allow me to handle the introduction: meet your plantar fascia. This fibrous bundle stretches from the heel of the foot to the ball, like a rubber band, providing an added layer of support to the arch. When this tissue becomes inflamed, the resulting condition is called plantar fasciitis.
This weight-bearing connective tissue is crucial in getting the propulsion one needs to say, dunk a basketball or perform the “Dance of the Little Swans” famous sixteen pas de chat from Swan Lake. While there have been many high-profile cases of planar fasciitis, including Kobe Bryant and Eli Manning, anyone who is on their feet all day, whether in a retail environment, a hospital, a construction site, or a classroom, runs the risk of overtaxing this taut tissue. Many of you are way ahead of me. Many of you rue the day you discovered plantar fasciitis was not a type of deciduous perennial.
It is just one of those injuries you don’t want. Like a pin prodding your heel, the pain is most noticeable first thing in the morning when you stand up out of bed or after long periods of inactivity throughout the day. While there are a plethora of traditional approaches toward taming the inflammation associated with plantar fasciitis, there is no surefire method. Milder techniques range from icing, stretching, and massaging, to purchasing a new pair of tennis shoes with a supportive arch. Yet, for those experiencing chronic inflammation, such measures equate oftentimes to little more than resting a Band-Aid upon one’s heel. Plantar fasciitis surgery, on the other hand, is generally recommended as a last resort as the risks are higher than found with most leg and knee surgeries. Complications include nerve damage; and due to the risky nature of the procedure, subsequent surgeries are frequently required.
One of the most prominent techniques today in countering plantar fasciitis is via the use of steroid shots. Yet, steroid shots are also a problem. Medical professionals have long been aware of the stopgap nature of cortisone injections, which, while definitively effective in the short-term reduction of inflammation caused by plantar fasciitis, have no long-term benefits. In fact, repetitive use of cortisone injections is discouraged as animal studies reveal that this can potentially result in permanent tissue damage. Thus, the ideal treatment for plantar fasciitis remains elusive. Or does it?
Physicians and researchers are actively in search of better methods to relieve the suffering of the millions of Americans not just in cases of plantar fasciitis but also with similar maladies involving chronically inflamed tendons and ligaments. Enter Platelet Rich Plasma, or PRP Therapy. This innovative technology has members of the medical community excited about its potential long-standing benefits for those daily facing the chronic pain induced by ailments such as plantar fasciitis.
PRP involves drawing upon our own body’s natural healing properties in order to regenerate problematic tissues. To better understand how this works, let’s take a trip back to seventh grade Life Science class. Blood consists of red and white blood cells that are suspended in plasma, along with platelets. This last component of blood, the platelets, are performers in time of injury, serving as first responders, initiating a collection of healing actions such as the encouragement of cell growth, the regeneration of tissues, and the cessation of bleeding via clotting.
Thus, PRP not only does the work of steroid shots in reducing inflammation, and thereby indirectly reducing pain, it also goes a step further and actually works to counter the degenerative effects of plantar fasciitis by introducing little repairmen in the form of platelets to initiate a series of restorative processes, healing from the inside out.
A collection of researchers actually performed a study in which steroid shots and PRP went toe to toe as shots were administered containing either cortisone or PRP injected into the plantar fascia of forty patients, with ultrasound guidance employed in both groups to ensure accuracy in delivery. Consistent with clinical results, the efficacy of steroid shots fizzled after the customary initial punch with members of this group demonstrating good results at the three-month marker before deteriorating into fair results at month six. In contrast, the new therapy, PRP, showed excellent results that were still maintained at the six-month marker.
The procedure is less aggressive and not nearly as expensive as surgery. Plus, the platelets are derived from the patient’s own blood, so there is little risk of the kinds of complications seen with surgery. Though long-term results concerning PRP therapy have yet to be determined, the practice has been performed since the early nineties.
