Plantar Fasciitis?
Do you have sore heels or arches of the foot? If your foot pain is interfering with how you move, how you feel and how you live, then it’s time to get help.
Plantar fasciitis is the most common cause of heel pain that we see and treat. It causes pain at the bottom and inner edge of the heel, and can range from mild to severe. If you dread those painful first steps in the morning or when standing after resting, there’s a good chance that the cause of your heel pain is plantar fasciitis.
What Is Plantar Fasciitis?
Plantar fascia, a connective tissue that fans out across your arch and helps stabilise and support your foot while you walk, run and move. When the plantar fascia is overloaded and strained, it can become injured, inflamed and can cause heel pain and arch pain. This is known as plantar fasciitis.
How To Treat Plantar Fasciitis
Treating your heel pain must be uniquely tailored to your level of injury, symptoms, daily activities and life. We’ll look at what caused the original damage to your plantar fascia, and what factors may be placing additional strain on the tissue, thereby affecting your healing and recovery. Arch support or orthotics are often an essential treatment modality that helps to reduce strain on plantar fascia. It offers almost immediate relieve with the long-term solution to prevent recurring of the condition. Treatment plan normally involves two stages – reduce current inflammation (laser therapy ect) and to stop an ongoing injury to Plantar Fascia so tissue starts to recover (orthotics and specific stretching/strengthening exercises).
How Long Does Plantar Fasciitis Take to Heal?
Plantar fasciitis and the associated heel pain can last on and off for months and years if it is not well managed and allowed to heal. At Phoenix Podiatry we see patients with heel pain on daily basis and most often we can provide relieve on the first appointment. Normally we see reduction of pain by 50% within first three weeks with 100% pain free in 3 months. Acute cases are easier to manage, so please do not delay your treatment. Occasionally a multidisciplinary approach might be necessary in stubborn cases, such as cortisone injection guided under ultrasound at a Radiology clinic for people who is not able to follow anti-inflammatory protocol due to their work or family commitment.
How Do You Get Plantar Fasciitis?
Anything that overloads your feet and stresses your plantar fascia can result in plantar fasciitis. This includes:
Spending long periods of time on your feet
Going too hard, too fast during exercise
Inadequately warming up your body before exercise
Your foot biomechanics, including both flat feet and high arches
Unsupportive or ill-fitting footwear
Training on hard surfaces like concrete
Sudden increase in weight
Age, which can diminish the fat pad beneath your heel
How To Know If You Have Plantar Fasciitis
You may feel:
Sharp heel pain and discomfort at the bottom and inside of the heel, which may radiate up into the mid-arch region
A ‘stone bruise’ type pain, like you are walking on a stone or a bony heel spur
Heel pain that is worst during the first few steps in the morning, and on standing up after some rest
Heel pain that is aggravated by physical activity and running
Don’t presume that all heel pain is plantar fasciitis
While plantar fasciitis is by far the most common form of heel pain, there are other causes of similar symptoms that are actually caused by nerve impingement, tendonitis, stress fractures or inflammatory arthritis. Only with a thorough history, physical examination and the services of an experienced clinician can an accurate diagnosis be made.
Plantar fasciitis doesn’t just affect flat feet
Plantar fasciitis is common whether you have flat feet, high arches, or a normal or ‘neutral’ arch. The real skill is to identify the cause of the condition, of which there are often many, and then establish the correct treatment plan. Generally, higher arched feet require a strict stretching program and flat feet require a gradual strengthening program and more support for the arch and fascia.
Heel cushions don’t cut it
Silicone or foam heel cushions, commonly available from pharmacies, do nothing to actually cure this condition. At best, they will provide some temporary comfort. The reason is that your fascia needs to stop being overused and excessively strained as you move in order to repair – which the soft heel cushions don’t help with at all. On the other hand, hard and flat walking surfaces are certainly not favourable. This is where custom foot orthotics create the best environment for healing, long-term repair, and future injury prevention.
Footwear matters
Too flat, too high, too cushioned, or too hard shoes can aggravate heel pain. Your podiatrist will provide you with advice based on your foot type, circumstances, occupation and preferences. They will always give you the best advice for a quick and optimal recovery.
Injections
Historically, many doctors advocated an injection of local anaesthetic and corticosteroid to alleviate the symptoms of heel pain. The symptom relief, however, can be as short-lived as a few weeks, and the injection itself can be very painful. Nowadays, injections are generally reserved for recalcitrant cases in conjunction with other treatments.
Remember, injections work to mask the symptoms of plantar fasciitis, and not treat or repair the problem itself. If you hear of people whose pain has come back worse after the injection has worn off than before they had it, this is why – while continuing to walk normally on their damaged tissue because they could no longer feel the pain, the injury itself worsened.
