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HEALTH} under the microscope Plantar Fasciitis Plantar Fasciitis is an inflammation of the plantar fascia, a thick band of tissues that runs from the heel to the toes. The plantar fascia is a thick band of connective tissue that runs along the bottom of the foot. Starting at the heel, the band fans out to connect to each of the toes. It's engineered to act as a shock absorber for all the pounding the body takes. However, all that pounding can cause small tears in the plantar fascia, creating an irritating, inflamed source of pain. Once the plantar fascia is damaged, the condition is called plantar fasciitis. Sufferers of plantar fasciitis describe the pain as most acute during the first steps taken after an extended rest, such as first thing in the morning. The pain often becomes less severe as the body loosens up through movement. However, the pain can return after a prolonged period of standing. What is it? Plantar fasciitis is known to affect those who exercise regularly, those who are overweight, those with a high arch, and those with a flat foot. Whether the cause is overuse through exercise, excessive weight, a hard landing, or our footwear, the result is the same: The arch drops, causing the fascia band to stretch and then tear. How do you get it? Once you've damaged the plantar fascia, you need to have a lifestyle change to correct it. Treatment generally takes between six and 18 months. Treatment could include a visit to a podiatrist to be fitted for orthotics. It may mean physical therapy or regular massage. Stretching and strengthening exercises are also among the top recommendations for treatment. Other common ways to treat plantar fasciitis include using devices such as a night splint, which looks like a brace and is used to provide a consistent and gentle stretch to the achilles tendon and plantar fascia. Another device looks similar to a large light switch. The foot lays flat on top of the device, and the toes slide the "switch" up and down, causing the arch to elevate, which provides a stretch for the plantar fascia. The pain associated with the condition is traditionally treated by using ice packs, anti-inflammatory medication, and even steroids. In rare cases, surgery is an option. How is it treated? If you suspect a client could be suffering from plantar fasciitis, refer her to a doctor immediately. The sooner the client is under the care of a doctor, the sooner she will be fitted for orthotics, referred to a physical therapist, or given other appropriate recommendations. Another consideration for techs is to sit with a physical therapist to learn the correct way to stretch and massage the foot on a client with plantar fasciitis. If a tech has a high number of clients who complain of plantar fasciitis pain, she could learn ways to offer relief and then become the "go-to" person for pedicures among runners or other high-risk clientele. What can a tech do? In most cases, the plantar fascia tears near the heel. Many times it is ignored and worsens until the repeated irritation and prolonged inflammation causes the body to develop a secondary problem: heel spurs. The body creates a bony spur because it's afraid the inflamed tissue will tear away from the heel. What else? David Martin, D.C., and William Smith contributed to this article. 112 | NAILS MAGAZINE | MARCH 2013 For more information about plantar fasciitis, log on to www.nailsmag.com/encyclopedia.