Cases of plantar fasciitis, a common orthopedic ailment, are on the rise during the COVID-19 pandemic, according to St. Vincent Charity Medical Center foot and ankle surgeon Dr. Duane Ehredt Jr.

“Plantar fasciitis is typically more common in runners over the age of 40, those who may be carrying extra weight or those with flat feet or high arches,” Dr. Ehredt said. “However, with people quarantining at home during the COVID-19 pandemic, many are replacing trips to the gym with daily running or walking. Then, they may come home and walk barefoot or wear flip flops the rest of the day. In addition, some have become more sedentary during stay at home orders.”

All of this, Dr. Ehredt said, contributes to an increase in cases of plantar fasciitis. The condition, which affects more than 2 million Americans each year, is the result of inflammation of the thick band of tissue – the plantar fascia – that runs across the bottom of the foot and connects the heel to the front of the foot. Designed to absorb the stress and strains placed on the foot, too much pressure combined with tightness of the calf or Achilles tendon can cause inflammation of the fascia. The result is stabbing or burning pain, particularly with the first steps of the morning.

The good news is with treatment, 90 percent of patients will feel a 90 percent reduction in their pain within 3 months.

Dr. Ehredt begins treatment by prescribing a night splint that keeps the foot at a 90-degree angle while sleeping to stretch the calf muscle and the Achilles tendon. Typically, the Achilles stretches as a person moves throughout the day and then regenerates and tightens as the foot is in a relaxed position while sleeping. This overnight tightening is what makes plantar fasciitis the most painful first thing in the morning.

“The night splint allows a long enough time to stretch, but I remind my patients that treating plantar fasciitis is not an overnight fix,” Dr. Ehredt said. “It took months or possibly years for the soft tissues to develop as they are and cause the inflammation, so it will take time for the body to adjust. I encourage patients to think of the night splint like a retainer – it’s something they should use on a continuing basis to keep the tissues in the right condition.”

In combination with the night brace, treatment includes:

Anti-inflammatories and ice;

Reduction in physical activities that may be contributing to the inflammation and additional physical therapy or stretching exercises;

Orthotics - For patients with flat feet, high arches or even an abnormal pattern of walking, the weight on the feet is often distributed in a way that places additional stress on the plantar fascia. In those cases, customized foot orthotics are recommended. Dr. Ehredt cautions, however, that not all orthotics are the same, so patients should rely on a trained specialist to prescribe the right type of device for the shape of their individual foot.

Cortisone Injections are a powerful anti-inflammatory effective in reducing acute pain from plantar fasciitis. Dr. Ehredt utilizes ultra-sound to guide the injection to ensure the cortisone is placed directly into the fascia, and not into the pad of the foot.

Surgery is considered in rare cases and only after 12 months of aggressive nonsurgical treatments.

To schedule an appointment with Dr. Ehredt, contact 216.241.8654