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Another Plantar Problem: Ruptured Plantar Fascia

Posted by on Monday, July 30th, 2012

We’ve talked a lot about plantar fasciitis, or the strain on your plantar fascia that causes inflammation and heel pain. However, plantar fasciitis isn’t the only trouble out there faced by your poor, scrappy little plantar fascia. Your plantar fascia can actually rupture.

Rupture? That sounds pretty extreme. A rupture is pretty extreme! Note that you have never heard anyone refer to a “minor rupture” or “mild rupture.”

First, just remind me what the deal is with the plantar fascia. There is nothing I would love more. The plantar fascia is a thick band of tissue that connects the forefoot to the heel. It runs under the arch of the foot, so as you can imagine, it takes a great deal of the weight of your body with every step you take or even when you just stand. It’s a lot like a bridge. That’s why plantar fasciitis is so common–your plantar fascia puts up with a lot so it’s easy for it to become inflamed.

So what’s up with a rupture? A rupture of the plantar fascia is much more extreme than plantar fasciitis. The strain that causes the inflammation of plantar fasciitis is a tiny tear or series or tears, somewhat like thin threads ripping in a pair of stockings. A rupture is a big tear.

How does that happen?!! Typically a rupture of the plantar fascia will come from some kind of traumatic event, such as jumping or falling and landing hard and direct on your foot. Sprinting at a high speed could also tear the plantar fascia from the extreme push off and positioning of the foot with each step. People with tight calf muscles are also prone to plantar fascia ruptures (and plantar fasciitis).

However, it seems like the tear doesn’t just come from the single event; rather, something may have weakened the plantar fascia. For example, there are medications that are associated with tendon or ligament tears. Steroids such as prednisone or antibiotics like Cipro have been known to weaken tendons or ligaments, which may cause a plantar fascia to tear when it otherwise might not have ripped. So if you’ve been taking any of these drugs, be careful about the amount of stress you put on your plantar fascia.

What are the symptoms? Pain in the arch of your foot, of course, both during activity or even while at rest. There may also be swelling or bruising in the area. People often report hearing a “popping” sound when the tear occurs, like a balloon bursting or if you think about it (which either means a) the popping sound is very loud b) these people have very good hearing or c) they happened to have their ear near their foot when the injury happened; I vote “c”).

It’s common for people to confuse a rupture of the plantar fascia with plantar fasciitis. If you have been treating suspected plantar fasciitis, and it doesn’t seem to be getting better, then you might have a rupture of the plantar fascia. To get an accurate diagnosis, though, you should have your foot examined by a podiatrist at The Center for Podiatric Care and Sports Medicine (212.996.1900).

How is a rupture of the plantar fascia treated? First you need to take weight off it. A podiatrist may put your foot in a cast or more likely in a walking boot for a few weeks. Ice helps and pain medication such as Tylenol is fine. After your foot is out of the boot, your podiatrist may recommend some stretches for your foot and your calf muscles.

When you start to put weight on it again, it’s a good idea to mix impact activities such as running with non-impact activities like swimming. Luckily, surgery is rarely required for a rupture of the plantar fascia.

So there! It’s not fun to have a ruptured plantar fascia but if you do take care of it properly, you’ll be fine. Protect your plantar fascia!

If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine LaiDr. Nadia Levy, and Dr. Ryan Minara have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.

14 Responses to “Another Plantar Problem: Ruptured Plantar Fascia”

  1. Rich Koetter says:

    Tore my fascia 12 years ago. Since then I can’t put any weight on the ball of my foot. I’ve been to several top notch Podiatrist’s around the Cincinnati area. Therapies, and even a surgery (metatarsal dorsiflexion with impingement) has only made my foot worse. I on my own came up with a thick rubber pad about 1/2″ thick and cut it to the shape of my foot. I then hollowed out the area of my pain at the ball of my foot. This has been the only saving grace for me over the last 12 years. Now any doctor I do talk to says there’s nothing more they can do because I’ve had 3 MRI’s over the years and they don’t show any mass or anything like that which would be the obvious source of my pain. This is a huge life problem for me, being 56 and not getting any younger. I feel very certain that my problem is a nerve entrapment or heavy scar tissue around the base of my 2nd and 3rd metatarsal. I’ve even had doctors and PT’s agree with that before they look at my MRI. We can put people on the moon and rovers all over the universe, but we can’t say for certain what’s going on at the ball of Rich Koetter’s left foot? It just doesn’t make sense to me. I’m willing to have another surgery if necessary but 4 podiatrist and 1 ortho surgeon don’t recommend it. Let them try walking like I do for the entire second half of their lives (if I am lucky enough to live to 90) and they’d be first in line to try another strategy to get back to no or minimal pain while walking. Anyway if there is anything you could enlighten me on regarding this I would be forever grateful. Sincerely, Rich Koetter

    • Jenn F says:

      Thanks for your comment, Rich! Please send your story to Dr. Geldwert directly for his medical opinion:

      http://www.healingfeet.com/contacts.php

    • Chris says:

      I also tore my plantar fascia 4 years ago (left foot)and the pain has not gone away. I wore a boot which healed it, then tore it again, wore a boot again to fix, then tore it again with very mild exercise. Now it wont heal at all. I’ve seen 2 foot doctors now and both got frustrated with my case and say exploratory surgery is my only option but could make the pain worse and they may not discover any condition. Ive had 3 MRI’s that dont show anything definitive other than inflammation and inconclusive evidence of a partial tear. There is not one day that goes by where I dont constantly think about the pain in my foot. I cant live like this for the rest of my life. Im only 33 years old. it really seems like there isnt an answer.

  2. Charlene A. Trajkovic says:

    Is it possible to have a tear from having had your foot twisted at the ankle and stuck under a seat, while hanging upside down from a seat belt?

  3. Amber says:

    I have been having foot issues for about six months now. The pain is in the arch of my foot and sometimes the heel. I have tried all stretches, ice, etc…to no avail. I do not have brusing and I did not hear a popping sound. Could I have a ruptured tendon?

  4. Sean says:

    So who is going to answer amber’s question.

  5. Elaine W says:

    I tore my plantar fascia a year ago and am still having problems. My little toe is numb and pain is still in the foot. I have trouble finding shoes that are comfortable. Some days are worse than others, I just push through it since I can not sit all the time with my feet up. I thought by now it would have healed up, wore a boot for about 3 1/2 months to begin with and still have a night boot to wear to bed. It helped a lot in the beginning but now not so much. I am tired of not being able to walk very much or far.

    • Jenn F. says:

      If your pain persists for more than 6 to 12 months, you may be a candidate for endoscopic surgery. Have you tried custom orthotics?

  6. Rita Roesch says:

    I had a MRI findings: severe acute plantar fascitis with marked thickening of the central cord of the plantar aponeurosis beginning near its origin extending for a length of 2 cm. There is superimposed 1. Grade partial to near full thickness tear of the central cord of the plantar aponeurosis at its origin measuring 5 mm, transverse. There is peri-facial edematous change. There is edema in the posterior heel pad. There is extensive edema in the medial and lateral soft tissues of the ankle which is a nonspecific finding. The rest shows normal. It will be 10 days before I see the doctor, my question is will I make things worse to push through pain and keep walking till then? I have family coming, foot is so painful ( more ankle pain ) but so much to do and want to be able to travel with them when ther’re here. Been in therapy 2 wks., only gotten worse, have brace, bed brace, and have had the plantar facia off and on since Feb. 2012. Also have severe ostiprocis, don’t know if that matters. ( age 57 ). Appreciate a response.

    • Jenn F. says:

      With standard plantar fasciitis, walking may actually be a good therapy, given icing to take down the swelling, anti-inflammatory medication like Aleve or Advil to manage the inflammation, and soft soled shoes with supportive heel cushioning. However, since you mentioned you have a cord TEAR, that is another story. Immobilization with a special boot is usually required until the tissues can repair themselves. I sympathize with your desire to travel and visit with your relatives. Is it possible to travel by scooter or bicycle? If the pain is terribly severe, perhaps you can rent a wheelchair. Some people find temporary relief with a cortocosteroid shot from the podiatrist. Please contact Dr. Geldwert directly for specific medical advice at 212-996-1900 or by email: http://www.healingfeet.com/contacts.php. Thanks for reading!

  7. Rita Roesch says:

    There is also mild distal Achilles tendininosis and tendinitis without tear. I have bought MANY ortho. To wear in shoes.

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