What is it?
Plantar fasciitis is an overuse injury that normally presents with pain on the inside and/or bottom of the heel that is worse with the first step in the morning. Pain may also increase when the toes are extended. Plantar fasciitis recovery can be lengthy and will require a gradual return to impact activities. When conservative measures have not helped to improve your symptoms,then a sports medicine physician may recommend an injection into or around the plantar fascia. Typically, the injection will include both an anesthetic, which should make your heel numb very quickly, and a corticosteroid. The corticosteroid is a potent anti-inflammatory that should give pain relief for a longer period of time. Occasionally, other substances like platelet rich plasma (PRP) may be injected.
Procedure and post-procedure guidance
An injection into or around the plantar fascia can be done with or without ultrasound guidance. The injection will be placed directly into the area surrounding your plantar fascia along the inside edge of the heel. Common risks of a corticosteroid injection are infection, nerve irritation and a very small chance of plantar fascia rupture. Also, there is a slight increase in pain during the first 24 – 48 hours after the injection, as the anesthetic wears off. However, the pain will subside and may completely resolve as the anti-inflammatory effects of the corticosteroid begins to work. After the injection, the physician may give the following instructions / precautions – Ice the heel for 20 minutes 3 times / day for the first 24 hours – Wear a walking boot for a period of time – Provide oral pain medication for the first few days – Instructions for cross-training and then a slow gradual return to impact training – Limit explosive training or activity for a period of time – Change running shoes, use arch supports or custom orthotics