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Foot and Heel Pain – Is it Plantar Fasciitis?

Posted on: May 9th, 2017 by The Physio Movement | Categories: Sports Medicine & Nutrition

Foot and Heel Pain

Known as Plantar Fasciitis, can be debilitating, especially your first few steps you take upon waking of a morning.

At TPM as a Sports focused multidiscipline clinic Foot and Heel pain is a condition we are very passionate about treating.

 

As NQ has such a high percentage of local league athletes and regular runners, a common complaint seen in the clinic is foot and heel pain. Generally, heel pain associated with running is most commonly going to be a plantar fasciitis  or fat pad contusion. Less common conditions include calcaneal fractures, nerve entrapments and extremely rarely more serious pathologies such as tumours. Over previous years, we have learned more about the plantar fascia then ever before, and with this have had changes not only in the definition of the condition, but how to manage them.

Plantar Fasciitis Townsville

The plantar fascia plays an important role in normal foot biomechanics. The fascia provides static support for the longitudinal arch of the foot and dynamic shock absorption. Plantar fasciitis in an oversuse condition of he plantar fascia at its attachment to the calcaneus (heel bone), is due to collagen disarray in the absence of inflammatory cells (Brukner & Kahn, 2014). This is where a recent change has occurred, the condition is more degenerative like a tendinopathy, not inflammatory as the name “itis” suggests. I have many runners come in to the clinic and tell me they’ve been told they have plantar fasciitis from other runners but have found that after a period of rest and NSAIDs, things are not improving

Plantar Fasciitis Townsville

Plantar Fasciitis Townsville

Typically, plantar fasciopathy is usually of gradual onset and felt classically on the inside aspect of the heel. Initially, it is worse in the morning and decreases with activity; often to ache post activity. Periods of inactivity (sitting down etc.) during the day are generally followed by an increase in pain. As the condition gets worse, pain may be present on weight bearing and all activity. Below are some common causes of plantar fasciopathy.

Plantar Fasciitis Townsville

Plantar Fasciitis Townsville

This condition can be acute, chronic or chronic with acute “flare ups”, similar to that of a tendon issue. Thus, there are treatments available that physio’s do in the initial stages for pain reduction including soft tissue techniques, taping, orthotics and give some stretches. However, this use to be the main focus of treatment for many years. Now we know there is greater benefit to treating these as tendinopathies. This is done through a gradual loading exercise program.

In 2014, Rathleff and colleagues conducted a trial comparing a gradual loading program versus shoe inserts (orthotics) and daily plantar-specific stretching over a 12-month period. They found that at 3 months, the strengthening program group had very significant improvements in symptoms compared to the stretching groups on a foot function index score. This is one of many studies looking into this which is confirming that plantar fasciopathy needs to include a progressive strengthening program, as well as address other biomechanical or muscle imbalances within the body. So if you are having heel pain and it is causing you issues with your exercise or daily activities, see a physiotherapist to help get you back to full function with a program designed just for you!

 

Book an expert appointment now with TPM Podiatry 

 

References

Brukner and Kahn. (2014). Clinical Sports Medicine, 4th Edition.

Rathleff, M., Molgaard, C., Fredberg, U., Kaalund, S., Andersen, K., Jensen, T., Aaskov, J., & Olesen, L. (2014). High-load strength training improves outcomes in patients with plantar fasciitis: A randomized controlled trial with 12-month follow-up. Scand J med Sci Sports. Doi: 10.1111/sms.12313

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     517 Flinders Street
Townsville City Qld 4810
     1300 TPM FIT or 4740 4516
     info@thephysiomovement.com.au
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