Plantar fascia is a real pain in the heel!

Plantar fascia is a real pain in the heel!

Plantar fascia, or plantar fasciopathy, is one of the most common causes of foot and heel pain particularly in the 40-60 year old age group and of course in runners!

Characteristics:What-is-Plantar-Fasciitis-and-How-Do-I-Treat-It-removebg-preview

  • Pain located on the medial plantar aspect of your heel where the plantar fascia inserts onto the heel bone.
  • Morning pain and stiffness on waking that can often improve as your foot “warms up.”
  • Aggravated by weight bearing activities such as walking, running and prolonged standing.
  • As the injury worsens the pain can be quite debilitating and very intense.

Why?

  • Changes in activity and load on the plantarfascia which is beyond the capacity of the tissue. For example, a sudden increase in type or intensity of activity.
  • Flat feet have been commonly been thought to contribute to the condition due to lowering of the medial longitudinal arch which increases the tensile loading within the plantar fascia.
  • Sudden changes in footwear can increase the workload on the plantarfasia. A classic example of this is when a patient returns from their beach holiday after wearing thongs for two weeks straight. Transitioning from wearing heels/work boots/dress shoes to thongs places a very different demand on the plantar fascia which results in overload of the tissue and pain.

Treatment:

Phase 1: Managing the pain:

  • Modify/Reduce activity levels
  • Education around footwear
  • Ice
  • Isometric exercises
  • NSAIDs (non steroidal anti-inflammatory medication)
  • Taping

Phase 2: Rehabilitation and building the plantar fascia activity tolerance.

  • Staged and progressive exercise-based program to help manage the pain and restore the loading capacity of the tendon.
  • Appropriate stretching of the calf and plantarfascia.
  • Address movement restrictions at the big toe and ankle to optimise long term recovery.
  • Improve the strength of the foot intrinsic muscles which help support the foot structure.

Things you might be thinking:

Are heel spurs the cause of my pain?

  • Heel spurs are very common and research has indicated there is no correlation to heel pain and having heel spurs. So best to just leave them alone.

plantar-a-1-removebg-previewShould I use gel shoe inserts?

  • Gel inserts can provide a lovely cushion for your heel when it is feeling sore. They won’t be the magical cure but can help manage your symptoms.

What about Shock Wave Therapy?

  • Extracorporeal shock wave therapy (ESWT) is designed to stimulate cellular repair. Studies indicate that shock wave therapy can be effective in reducing the pain associated with plantar fascia.
  • Shock wave can be an effective treatment option when used in conjunction with activity modification and a rehabilitation program.

Should I get foot orthotics?

  • Foot orthotics have been shown to help reduce pain in patients with a 6-12 week history of heel pain.
  • Anecdotally there is evidence to support the prescription of orthotics if the patient feels it helps to alleviate their symptoms.

How long will it take?

  • Average recovery time is 3-6 months. A small percentage of the population can take years to fully recover. Addressing the symptoms early is key to reducing the chronic nature of the condition.

Key tips:

  • Get early management and guidance from your physiotherapist or podiatrist.
  • Respect the pain.
  • Remember our body likes steady and progressive changes in activity to allow strength adaptation.

If you need to book and appointment email Cara at cara@nickhosefitness.com.au. Or book online via the Nick Hose Fitness website.

You can also book online by clicking the link below.

 

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