Plantar Fasciitis or more commonly known as a ‘Heel Spur’ is an injury to the heel area. Plantar means the sole of the foot and Fasciitis means inflammation of the fascia. The fascia is a type of soft tissue that supports the foot. In fact, research leads us to think inflammation is not the primary driver of pain but more degeneration or ‘wear and tear’ of the Plantar Fascia. The injury acts similar to a Tendinopathy (What is Tendinopathy?).
In some cases what a client think is Plantar Fasciitis can be an Achilles Tendinopathy. These are two different pathologies and must be treated differently.
Plantar Fasciitis is a degenerative process. It happens gradually over time. It is common in field sports, runners and non-active people. Typically symptoms include pain around the Heel, very painful in the morning, pain along the arch, pain on moving or at rest.
Avoiding aggravating factors is important to help the Plantar Fascia to heal. The Plantar Fascia needs to be unloaded by gaining mobility and strength in the calf and ankle. Lower limb strength can play a role in healing Plantar Fasciitis.
A thorough History and Physical Examination by your Chartered Physiotherapist will determine the likelihood of a Plantar Fascia Injury. If the examination shows an obvious Plantar Fascia Injury then a series of exercises and advice will be prescribed. These exercises will be progressive in nature to help the healing process. Shockwave Therapy should be considered in the case of Plantar Fasciitis. All loading protocols are research based and proven to be effective in the management of Plantar Fasciitis.
Following your Initial Consultation, a strict set of exercises as per our Plantar Fasciitis Protocol will help in a full return to sports or normal life. The protocol consists of progressive loading for the fascia and calf muscle to aid healing.
MyPhysio’s thoughts on Plantar Fasciitis
As with all injuries, our Chartered Physiotherapists consider strength and mobility throughout the body not just where the pain is. In the case of Plantar Fasciitis, perhaps a stiff ankle or poor pelvic control will be contributing. All these issues will be addressed at your Initial Consultation. On occasions temporary orthoses are used to help re direct the forces about your foot. These are not a magic fix, they must be used in conjunction with your prescribed exercises.
Footwear is very important and this will be discussed at your Initial Consultation. Definite things not to do such as wearing flip flops or walking bare feet are a must. Controlling load is key. Load meaning; how much walking/exercise/standing you are doing. If you have a very active job where you are on your feet all day then this must be taken into consideration when designing your rehab programme.
If you have any queries regarding Plantar Fasciitis or Heel Spur, please ‘Ask the Expert’.