April 29, 2008
This very painful condition is often caused by a condition called Plantar fasciitis, (also known as Policeman’s Heel or Heel Spur), and can really affect a persons work, sporting and social life.
What causes it?
- In my experience, something as simple as standing on a child’s marble or piece of escaped Lego is enough to start the irritation which leads to heel pain.
- People with high aches or dropped arches may be at higher risk.
- Shoes with thin, unsupportive soles are often implicated.
- Standing for long periods on hard surfaces, hence policeman’s heel, is often blamed.
- Obesity can be a factor, particularly in slowing down healing.
Less common causes include tendonitis, bruising from a heavy landing, stress fractures, collagen diseases and arthritic changes.
What and where is my plantar fascia?
What is plantar fasciitis?
If a word ends in ‘itis’, it means inflammation,(tonsil-itis, appendic-itis, arthr-itis, and so on). When the plantar fascia becomes injured or irritated, inflammation often results in ‘fascia-itis’, which we then we call fasciitis.
How do I know if I’ve got it?
The commonest symptoms are;
- Pain under the heel.
- Pain that is usually very much WORSE when you FIRST get out of bed.
- Pain that is worse AFTER sitting for more than about 20 minutes, (variable).
- Pain that INCREASES over a period of months.
- Pain that EASES as you get beyond the first few steps. This is because the fascia stretches as you walk.
How long will it last?
How long is a piece of string? Anything from a few weeks to several years is the gloomy answer. Basically, the sooner you seek treatment the better the outcome.
Who can diagnose it for you?
Physical therapists such as Registered Osteopaths and Chartered Physiotherapists are trained to diagnose and treat this painful problem. Both of these specialists are available at the Adur osteopathic Clinic.
Some patients will prefer to seek advice from their GP. Your GP will also see this condition regularly.
While X-rays, and MRI scans might be used in some cases, the diagnosis will usually be made on the description and history that you give us.
What can you do about it?
Your Osteopath of Physiotherapist will use a combination of treatments that may include some or all of the following;
Massage, therapeutic ultrasound, dry-needling therapy, (similar to acupuncture), and then advice on footwear and stretches with exercise. (See below).
Often the role of the therapist is to monitor and adapt the treatment and self-help as the fasciitis improves.
Shoe inserts, orthotics and arch supports can be very effective and while you can buy these in outlets like Boots and Scholl, ask your therapist for guidance. It’s not a perfect science and can be very expensive.
Your GP may, in some cases difficult cases, suggest cortico-steroid injections to help reduce the inflammation and relieve pain. Your Osteopath or Physiotherapist will refer you to your GP or Specialist if they feel it is necessary.
Night splinting helps to stretch the plantar fascia over a long period while you sleep. This helps some people to suffer less from the early morning pain. Unfortunately it doesn’t work for everyone. Discuss this with your therapist.
- Rest your heel on an ice pack for 5 to 8 minutes, (3 times a day if practical).
- Reduce activity that keeps you on your feet.
- Get the weight off. Start that diet you’ve been meaning to go on!
- Rub on NSAID, non-steroidal anti-inflammatory drugs in cream/gel form. Follow the instructions. They can help reduce inflammation but are not for everyone.
- CHECK WITH YOUR PHARMACIST IF ON ANY MEDICATION, ESPECIALLY BLOOD THINNING DRUGS LIKE WARFARIN. DO NOT USE IF ASTHMATIC, PREGNANT OR HAVE OR HAD AN ULCER. IF IN DOUBT DON’T USE.
- Always wear supportive, well-fitting shoes, even around the house. Slippers are fine, but mules are not!
- Stretching your calf muscles may help ease pain and assist with recovery.
Exercise One – reduces calf tension and plantar fascia stress.
- Stand facing a wall with one foot in front of the other.
- Keep your heels flat on the ground and bend both knees until you feel the calf muscles stretch.
- Hold stretch for 30 to 45 seconds.
- Relax and then repeat 3 times.
Exercise Two – pressure and cold therapy at the same time.
- You can use a rolling pin for this exercise, but I tend to use a frozen drinks can. Just freeze a bottle of water or can of cola and make sure you are wearing a sock.
- Place the can on the floor
- Roll the can back and forward with the sole of your bad foot. It gives a good stretch and cold therapy at the same time.
Commercial Calf & Plantar fascia Stretchers
Adur Osteopathic Clinic
Osteopathy, Physiotherapy, Ultrasound Scanning Physiotherapy Aromatherapy Dry-needling Reflexology Shiatsu, hypnotherapy, EFT & NLP Sports Massage
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