Plantar fasciitis is a painful condition affecting the sole of the foot, commonly in the heel. Those with the condition dislike pressure placed on this area. With the correct management, plantar fasciitis will resolve with conservative treatment. Plantar fasciitis is the most common cause of pain in the heel.
Harpreet Puri
T
Registered Physiotherapist
he plantar fascia is the thickened tissue on the sole of your foot. It pads the foot as well as having elastic properties to help transmit the forces of the calf muscle, allowing you to spring. It provides shape to your foot arch, providing shock absorption and an even distribution of your weight as you put weight through your leg. If too much demand is placed on the plantar fascia, it can inflame and become painful. This can come about through increased activity, for example on a hiking holiday, or with increased stretch on the tissues, such as swapping to unsupportive sandals in the summer from the usual supportive lace up shoes you wear the rest of the year. Recognising the early warning signs is key to a speedy recovery.
Plantar Fasciitis planter fascia pull on the heel bone from opposite directions eventually results in breaking of the weakest link of the chain. Sometimes it will present as Achilles tendonitis and at other times it will present as planter fasciitis. More common presentation is planter fasciitis.
Avoid overdoing the things that particularly provoke your pain. Weight bearing activities such as walking and running are common aggravators, so temporarily reduce these or substitute them for swimming or cycling which do not put so much load through the plantar fascia. Address your footwear. If you tend to walk around in flat, lose unsupportive shoes, wear lace up shoes with a good arch support. Roll an ice bottle under your foot. This not only acts to reduce inflammation, but also helps to gently stretch the tissues. Stretch regularly throughout the day, ensuring you hold these positions. This will help to reduce any excess load on the plantar fascia. Remember, plantar fasciitis can take some time to settle, so be patient, and persevere with your treatment. In time, you will get back to doing what you love most. In cases where the home management is not producing results or recovery is taking longer than expected, physiotherapy intervention can help. A typical encounter with any uncomplicated case of plantar fasciitis will look something like what follows. Patient- hi, I have been experiencing pain at the bottom of my heel from last three months. I was wondering if you can help me with it. Physiotherapist- I will be happy to be of assistance. Before we proceed let me ask you a few questions to find out exactly what we are dealing with here. Patient - I have had x-rays done and my doctor has told me that I have heel Spurs. My pain is most bothersome first thing in the morning when I step out of bed. After that it improves a little, but it can come back if I walk or stand a lot during the day.
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Physiotherapist- that sounds like a very typical presentation planter fasciitis which has not healed in an expected time frame. It is normal for people to have pain for more than three months. Patient- I would also like to add that it hurts a lot if I touch the inside of my heel bone at the bottom of the foot and sometimes it feels like a sharp object is stuck there. Physiotherapist- this is consistent with the planter fasciitis. The most common reason for developing planter fasciitis is repetitive overuse of the lower extremity. The best management of planter fasciitis involves examining the bottom of the foot, planter fascia, Achilles tendon, calf muscle, nerve mobility and lumbar mobility. Any one of these sites could be the primary reason for ending up with planter fasciitis. In physiotherapy management a physiotherapist will assess and diagnose to make sure that the best care is given. Research suggests that the most promising modality that is used in managing planter fasciitis is shockwave therapy. Over 90% of patients report significant improvement within five to seven sessions of shockwave therapy, at a 5 to 7 days of interval. As I said earlier, considering the whole lower extremity chain, almost all patients would make satisfactory recovery by making sure that all the components of lower extremity chain are in good shape.
Another reason is the reduced nerve mobility of sciatic nerve that supplies the calf muscles. Having reduced mobility in sciatic nerve also results in tightness of the calf muscle. An important part of the management will involve making sure that the nerve mobility is normal. A physiotherapist will typically do stretches in the clinic and give home exercises to make sure that this is taken care of. For the treatment of trigger point dry needling or IMS is remarkably effective. Dry needling involves inserting acupuncture needles in the trigger points that has been shown to be amazingly effective management. Single intervention may not be as effective as combination of interventions done by an expert. Patient: Can I have more information about Shockwave therapy. Physiotherapist: Sure. Shockwave is an acoustic wave which carries high energy to painful areas and soft tissues with subacute, sub chronic and chronic conditions. This energy promotes healing, and the regenerating and reparative processes. It is a unique, non-invasive solution for pain associated with the musculoskeletal system. At our clinic we use state of the art BTL shockwave therapy. Point your phone camera at the QR code to get more information if you are interested.
The most common reason for that posterior chain tightness is overuse of calf muscles where trigger points develop in the muscle. These trigger points are hypersensitive strands of muscle fiber that increase the resting tone of the muscle. The tension in calf muscle and the natural tension in the www.entertainmentmagazine.ca
