The kneecap (patella) is a small bone in the front of the knee. It glides up and down a groove in the thigh bone (femur) as the knee bends and straightens. The patellar tendon is a thick, ropelike structure that connects the bottom of the patella to the top of the large shin bone (tibia). The powerful muscles on the front of the thigh, the quadriceps muscles, straighten the knee by pulling at the patellar tendon via the patella. Patellar tendinitis is the term used to describe inflammation of the patellar tendon.

Patellar tendinitis usually occurs as a result of overdoing an activity and placing too much stress on the patellar tendon before it is strong enough to handle the stress. This overuse results in "micro tears" in the patellar tendon which leads to inflammation and pain. Over time damage to the patellar tendon can occur. In extreme cases, the patellar tendon may become damaged to the point of complete rupture.

Patellar tendinitis is common in people involved in activities that include a lot of running, jumping, stopping and starting. Pain from patellar tendinitis is felt in the area just below the patella. There may be swelling in and around the patellar tendon and it may be sensitive to touch. The pain can be mild or in some cases the pain can be so bad that it prevents athletes from playing their sport. This condition is also known as "jumper's knee" because it is frequently seen in sports that require a lot of jumping.

 

Plantar Fasciitis is an inflammation caused by excessive stretching of the plantar fascia. The plantar fascia is a broad band of fibrous tissue which runs along the bottom surface of the foot, attaching at the bottom of the heel bone and extending to the forefoot. When the plantar fascia is excessively stretched, this can cause plantar fasciitis, which can also lead to heel pain, arch pain, and heel spurs.

 The excessive stretching of the plantar fascia that leads to the inflammation and discomfort can be caused by the following:

• Over-pronation (flat feet) which results in the arch collapsing upon weight bearing
• A foot with an unusually high arch
• A sudden increase in physical activity
• Excessive weight on the foot, usually attributed to obesity or pregnancy
• Improperly fitting footwear

Over-pronation (flat feet) is the leading cause of plantar fasciitis. Over-pronation occurs in the walking process, when a person's arch collapses upon weight bearing, causing the plantar fascia to be stretched away from the heel bone.

With Plantar Fasciitis, the bottom of your foot usually hurts near the inside of the foot where the heel and arch meet. The pain is often acute either first thing in the morning or after a long rest, because while resting the plantar fascia contracts back to its original shape. As the day progresses and the plantar fascia continues to be stretched, the pain often subsides.

The key for the proper treatment of plantar fasciitis is determining what is causing the excessive stretching of the plantar fascia. When the cause is over-pronation (flat feet), an orthotic with rearfoot posting and longitudinal arch support is an effective device to reduce the over-pronation and allow the condition to heal.

If you have usually high arches, which can also lead to plantar fasciitis, cushion the heel, absorb shock and wear proper footwear that will accommodate and comfort the foot.

Other common treatments include stretching exercises, plantar fasciitis night splints, wearing shoes that have a cushioned heel to absorb shock, and elevating the heel with the use of a heel cradle or heel cup. Heel cradles and heel cups provide extra comfort, cushion the heel, and reduce the amount of shock and shear forces placed during everyday activities.

Every time your foot strikes the ground, the plantar fascia is stretched. You can reduce the strain and stress on the plantar fascia by following these simple instructions: Avoid running on hard or uneven ground, lose any excess weight, wear shoes and orthotics that support your arch to prevent over-stretching of the plantar fascia, and participate in good pre-activity warm-ups, stretching, and off-season training.

For more information about the pain in your foot, please call one of our offices to speak with a therapist!