Plantar fasciitis, a real pain in the……. heel
Plantar fasciitis is one of the most common conditions that we treat in the clinic, and it can be an extremely frustrating condition. It will affect around 10% of the population and makes up around 15% of all adult foot complaints.
The plantar fascia is a broad band of dense connective tissue similar to tendon and ligament that originates from the heel bone (calcaneus) and inserts into each of the toes, forming a fan shaped structure. It serves an important role in foot and lower limb mechanics.
What does it feel like?
Patients suffering from plantar fasciitis will typically complain of pain affecting the underside of the heel, especially when getting out of bed in the morning. The pain may improve after a few minutes of walking but will return after prolonged periods of standing, walking or running.
Who gets heel pain?
In the athletic population plantar fasciitis is common in long distance runners, footballers, dancers and basketball players. It has been quoted that 10% of those who are active in running sports will develop plantar fasciitis. In the non-athletic population plantar fasciitis is more likely to affect you if you are overweight, in a weight bearing occupation, over 50 years old or have limited range of movement at the ankle joint.
It isn’t caused by inflammation
Plantar fasciitis is caused by increased load on the plantar fascia. Despite what you have been told it is now thought that plantar fasciitis is NOT an inflammatory condition. It is now thought that the process is more likely a degenerative one and the literature supports this. As a result Podiatrists and other health care providers have started to describe the condition as plantar fasciopathy or chronic plantar heel pain (CPHP) to reflect this change in thinking.
What to do at home
1) STRETCHING of the calf muscles is a good place to start when you develop heel pain. Stretching the sole of your foot has also been shown to help with the pain associated with this condition.
2) ICE Although there is little (if any) inflammation involved with this condition, ice works well as an analgesic and will help control the pain, especially if you’ve had a long day on your feet.
3) FOOTWEAR is a really important part of treating heel pain. Generally I would recommend a cushioned shoe such as a running trainer with a heel height of around 10mm. This type of shoe offers arch support, shock absorption/cushioning, is light and comfortable to wear and also allows me to accommodate special insoles if necessary.
4) AVOID BAREFOOT WALKING, it is likely that this will aggravate your symptoms.
5) REST Avoid high impact sports that include running or jumping. If you are in a weight bearing occupation, this can be very difficult. Try to modify your work day so that you spend less time on your feet.
6) WEIGHT-LOSS If you are overweight you are more likely to develop heel pain. Losing weight is recommended as a preventative measure and also as part of treating the condition.
When to get help
Just because you have a painful heel, it doesn’t mean that you have plantar fasciitis. Other conditions that also cause heel pain include stress fractures, bony bruising, fat pad bruising, nerve irritation and some forms of inflammatory arthritis. As always it is vitally important to get an accurate diagnosis of your condition before undertaking any treatment plan.
It is recommended that you seek help from a Podiatrist. If you are suffering from heel pain or know someone who is you can BOOK NOW.