Planter Fasciitis - A common cause of heel pain
When one of our members asked for information about Planter Fasciitis, our first thought was how do we explain this properly? With so much information out there how do we make sure we give the correct information? So it was an easy decision to refer this one onto a trusted local expert in the field.
Harmeet Singh Sethi, Physiotherapist at Olympic Sports Clinic Hallett Cove, provides an insight about this condition.
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What is it and what causes it?
Planter Fascia is a soft tissue structure, which supports the arches of ones feet. It provides support and dynamic shock absorption. It arises from the heel bone (calcaneus) and inserts into the toes.
Planter Fasciitis is an overuse condition, the pathology of which is similar to tendinopathy (commonly known as tendonitis but there is actually no inflammation, hence a misnomer).
There are several contributing factors towards development of this condition, some of which are as follows:
Activities such as running and dancing.
Sudden increase in load, e.g. sudden increase in activity level after long period of inactivity (I commonly see this before City to Bay when someone who has been sedentary/inactive, suddenly starts walking/jogging long distances – sudden increase in load on feet)
Obesity/sudden weight gain
Tight calves, hamstrings and gluteal muscles
Hip muscle strength imbalances
What are the symptoms?
Clinically pain is felt over the inner aspect of the heel. One classical symptom is pain in the morning especially during the first few steps. In severe cases, pain may be present when weight bearing and worsens with increase in activity especially by the end of the day.
How is it diagnosed?
Assessment requires detailed history and biomechanical assessment. Physiotherapists are very well trained to asses this condition and could help in the diagnosis. If necessary, investigations such as x ray and ultrasound scan should be considered.
One myth which goes with this condition is that Planter Fasciitis is related to a heel spur. Many times patients refer their condition as “heel spur”. It has been confirmed by research that the heel spur, if found on x ray, is not causally related to the pain.
How can it be treated?
There is no particular treatment of this condition, however one thing we know is that this is a self-limiting condition. Planter fasciitis could take up to a few months to a couple of years to resolve. The key to addressing his condition, first of all is to identify and address contributing factors. This may involve advice to lose weight, orthotics, addressing biomechanical impairments etc.
Stretching of Planter Fascia is commonly prescribed but I do not recommend this to my patients. As Planter Fasciitis is an over use (wear and tear) condition, it does not make sense to stretch something, which is already going through the process of wear and tear.
Based upon patient’s presentation, irritability, chronicity of the condition, various treatment options are available. Some of commonly available treatments are: massage, night splints, heel gel pads, exercises, strapping, dry needling, cortisone injection, soft tissue therapy, shock wave therapy and in extreme recalcitrant cases surgery.
Physiotherapists are best placed practitioners to assess and treat this condition as they have extensive knowledge in anatomy, physiology, biomechanics and pathology.
In my personal experience majority of our patients report relief and reduction in their symptoms after physiotherapy intervention. Generally patients feel comfortable to an extent that they can continue with their activities of daily living and sports. As mentioned, this is a self-limiting condition and ultimately in majority of the cases should resolve with time.
For further information about this or any other physio related injuries, please contact Olympic Sports Clinic Hallett Cove on 8387 2788.