Heel pain is the most common condition podiatrists see on a daily basis. Most people at some stage in their life will develop heel pain, with plantar fasciitis/fasciopathy the most common cause.
What is the Plantar Fascia?
The plantar fascia is a thick band of tissue that originates at the heel and inserts under the ball of the foot. Its main role is to strengthen the foot and provide an adaptable mechanism that absorbs the force of foot strike and then transfers it into propulsion as the foot pushes forward. Like the string on a bow it helps maintain the shape of the foot and has an important role in the way our foot functions when we run and walk.
What are the Symptoms?
Patients often describe the pain as a hot poker stabbing into the heel with the pain often noticeably worse in the mornings or after prolonged periods of sitting. It is either caused by micro tears in the plantar fascia or direct compression force at the heel that overtime causes scar tissue. The pain tends to develop insidiously and eventually becomes very debilitating.
What causes Plantar Fasciitis?
The cause of plantar heel pain is strongly linked to foot function and structure. If a foot is excessively everted (heel rolls in) and pronated (arch flattens) then the plantar fascia is placed under increased stress due to tensile force. However, there is new evidence suggesting that direct compression force and heel spurs that can also lead to tissue damage at the plantar fascia.
Treatment
In the treatment of plantar fasciitis it is important to firstly treat the symptoms such as pain and inflammation. In the first 4-6 weeks it is appropriate to treat the condition similiar to a soft tissue injury. Therefore ice, compression and rest are indicated. However for most people they present outside this timeframe and has become a chronic injury and more intensive treatment is required. At the chronic stage, regular soft tissue treatments such as massage, ultrasound, dry needling and stretching are required to provide symptom relief and encourage scar tissue breakdown and healing.
To determine if foot posture and mechanics are a contributing factor, a comprehensive gait assessment by a sports podiatrist is required. This will highlight any biomechanical issues that may be the underlying cause of the problem. Orthotics are one of the frontline therapies for the treatment of plantar fasciitis and correcting foot alignment issues and have proven success in eliminating heel pain.
Our Service
At Melbourne Podiatry Clinic we use a contemporary method of orthotic therapy. Using the Foot Alignment System™, we are able to realign and support the foot to offload the plantar fascia in stance. Our weight-bearing method provides the exact level of support your foot needs to provide relief when you are running or walking and targets the underlying cause. This is key in the treatment of this problem as the tensile or compression force on the plantar fascia needs to be reduced before it begins to heal. In addition, using a weight-bearing method means the orthotic is extremely comfortable and requires minimal ongoing adjustments so you can get back to running with less hassles!
