Dr. Holdren Otis

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The plantar fascia is a ligament on the bottom of the foot that goes from the heel bone to the bases of the toes

Manning is currently listed on the injury report as right shoulder, rib and left foot injury. There are differing reports about what caused him to leave the game Sunday after throwing 5 passes and 4 interceptions again the Kansas City Chiefs. Peyton Manning has struggled with plantar fasciitis over the season. Plantar fasciitis, also known as heel spur syndrome, is the most common cause of heel pain. It is seen in individuals who are physically active or have increased their daily activity. The plantar fascia itself is a thick band of tissue attaching to the heel bone, the calcaneus. Tugging and pain are usually felt at this attachment, but pain can be in the arch as well. This tugging can cause microtears or worse a partial rupture of the fascia itself.  Pain in the morning and when getting up to walk after sitting for a period of time are common complaints. The heel is often painful when a person has to push off on the toes.

Treatment for microtears of plantar fasciits is much different from treatment of a partial or complete tear of the fascia. Microtears are treated with a decrease in activity, especially what causes the pain. The foot and arch itself needs to be supported with an arch strap or insert in the shoes so that the fascia doesn’t have to stretch so much with each step. The longer the symptoms have been around the longer it takes to make the pain go away. If the pain is not going away with diligent care for 6 months then a surgical procedure can be done through a scope to lengthen the fascia.

A partially torn plantar fascia is an uncommon injury but can be done with one forceful planting of the foot. Sometimes a pop is felt or heard with associated pain.  It is not possible to repair the plantar fascia surgically. Time and rest with gentle stretching are the main treatments.  Soft tissue, such as the plantar fascia, can take up to 8 weeks to fully heal. Immobilization with a walking boot or cast can help to heal it faster and is recommended for a fully ruptured plantar fascia. Once the fascia is healed light stretching and slowly getting back into activities is the best way to prevent a re-rupture. Peyton’s brother Eli Manning tore his fascia completely in 2009. There is no genetic link to pathology of the plantar fascia but they may have a similar foot type, along with high level athletics that would predispose them both to this issue.

Peyton Manning broke the record for the most passing of all time earlier in the game. For the sake fans of the Broncos and Peyton Manning hopefully microtears of the fascia along with the shoulder and ribs kept him out of the game and not something more serious like a partial or complete rupture.