Intro
Plantar Fasciitis is the most common cause of heel pain in our patients. It actually affects 1 in 10 people! It is a painful condition that can affect people of all ages and activity levels. Thankfully, your sports podiatrist is an expert in diagnosing plantar fasciitis, and there are a number of brilliant treatments to help with the pain. Podiatrists spend all day looking at feet so we are very diligent at diagnosing plantar fasciitis.
What is Plantar Fasciitis?
Plantar Fasciitis is a pain that originates in the heel and can radiate further back or towards the toes. When plantar fasciitis occurs, when the plantar fascia (different to ligament and tendon) becomes irritated and inflamed, recently we know that it may be micro tears to the fascia. It may also become thicker due to the body trying to repair itself. The plantar fascia is a strong, dense structure that is located at the base of the foot. It connects the heel bone to the toe bones at the ball of the foot. The plantar fascia’s function is to help with weight bearing and force distribution through the foot when a person walks. It also assists the arch of the foot to stay supported in an upright position.
What are the symptoms of Plantar Fasciitis?
Plantar fasciitis causes some characteristic signs and symptoms in its patients. Some of these include:
Sharp, stabbing or burning pain in the base of the heel
Pain that is usually at its worst when getting up out of bed in the morning, but typically subsides after a few minutes of walking
Pain after prolonged periods of sitting or standing
Pain immediately following a period of intense exercise
Risk factors; What increases my chances of getting Plantar Fasciitis?
Plantar fasciitis can happen to people of any age and activity levels, however there are risk factors that can increase a person’s chances of developing the condition. Some of these risk factors include:
Age: people aged between 40 and 70 are at greatest risk
Gender: females are at greater risk than men
Pregnancy: females often experience bouts of plantar fasciitis during pregnancy, especially with sudden weight gain and ligament laxity (estrogen changes)
Overweight and obesity increase a person’s risk of developing plantar fasciitis (more pressure)
People who run often or over long distances are at increased risk (increased load)
Occupation: people whose jobs require them to be on their feet for long periods are at increased risk
Structural problems of the lower leg and foot: people who have high arches, flat feet, or tight Achilles tendon and calf muscles are at increased risk
Footwear: wearing very flat or unsupportive footwear such as ballet flats or flip flops increases a person’s risk of developing plantar fasciitis.
How do I diagnose Plantar Fasciitis?
Your Podiatrist is an expert in diagnosing plantar fasciitis. The diagnosis of plantar fasciitis is often made based upon the patient’s presenting symptoms and clinical signs. We also take into consideration your medical history, lifestyle, medication and previous injuries. We conduct a thorough physical examination, including palpating the foot to see if the pain can be pin-pointed or reproduced. A biomechanical analysis is carried out in most cases, in order to assess the patient’s gait (style of walking or running). This allows your podiatrist to determine if there are any structural abnormalities, muscle imbalances in the lower limb and foot that could be contributing to plantar fasciitis. In some situations, diagnostic imaging, such as an ultrasound or xray may be required in order to rule out other differential diagnoses such as stress fracture, rupture or nerve issues.
What are the treatment options in MyPodiatry?
Through experience, curiosity, trial & error, Stephen has developed methods of treating plantar fasciitis that exceed what the latest research says. Some research says it takes 12 months to fix plantar fasciitis. However, Stephen needs 10-12 weeks before the same success is achieved.
Initially Stephen will diagnose plantar fasciitis and figure out exactly what causes it. Some patients may require biomechanics assessments or further imaging.
The treatments include;
- Athletic Taping to support the plantar fascia.
- Joint mobilisation to loosen out any stiff joints.
- Dry needling, massage, trigger point therapy all with the same goal as loosening out the muscle
- Footwear advice.
- Foot Orthoses (orthotics/insoles). They are usually dependent on the patient. Some patients don't need them and I don't go handing them out like candy!!
- Stretching
- Strengthening
- Co-Contraction exercises
- Isometric / concentric / eccentric loading
- Walking / Running re-training
I don't do all of these for everyone. IT DEPENDS on what is the presenting complaint.
I am currently learning myofascial meridians which may benefit some patients! You hip or lower back could be causing your heel pain.
Stephen McCarthy
BSc. (Hons) Podiatric Medicine, MSCIP.
0896171046
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