All Posts tagged podiatry

Foot Pain: Plantar Fasciitis

Foot Pain: Plantar Fasciitis

Foot Pain OUCH!

You leap out of bed in the morning and you get stabbing pains in your heels or the arches of your feet. You hobble a few steps, and then hobble a few more until the pain reduces. Most of the day your feet feel OK …except when you tackle stairs or when you have been sitting for a while when the pain makes a reappearance.
Pain in your heel or the bottom of your foot is most commonly caused by Plantar Fasciitis. Your Plantar Fascia is the ligament that goes from the underneath of your heel to your toes. If you strain it, micro tears can form, which leads to swelling and sharp pain.
While most people experience the pain in their heel, some also get pain through to the arch of their foot. In about 70% of cases, the pain is in both feet, making walking a very painful experience.
You most commonly notice the pain first thing in the morning when you get out of bed and it reduces as your feet warm up with movement. It can reappear during the day after periods of rest or sitting, if you have been standing for a while, or when climbing stairs or ladders.
Plantar Fasciitis is more common in middle-aged people, although it can also affect younger people who use their feet a lot like joggers, dancers, or soldiers. That’s why it is also often called Joggers Heel.
Causes of Plantar Fasciitis
While the actual causes of plantar fasciitis are not known, there are risk factors that will increase the likelihood of you getting plantar fasciitis.

Overuse – excessive running, walking or dancing, or changing your training pattern so you dramatically increase hill running (for example).
Standing on hard surfaces
Flat feet or high foot arches (this is one time when average is better!)
Middle age
Being overweight
Tight Achilles tendons or calf muscles
Your feet roll in when you walk or run
Ill-fitting shoes, worn out or unsupportive footwear such as thongs/slides
Walking barefoot on hard surfaces
Pregnancy

First aid for Plantar Fasciitis

Generally, plantar fasciitis is gradual onset, which means it gradually increases in severity over time. If you ignore it and try to run through the pain, then the symptoms can get worse, ultimately leading to you changing your gait, limiting your activity or triggering the growth of heel spurs.
For initial symptoms, you need to rest, apply ice packs (15 minutes at a time every 2-3 hours), and take anti-inflammatory painkillers such as ibuprofen.
You don’t need a referral from a doctor to see a physiotherapist. If the pain is moderate then you can seek treatment with your Physiotherapist immediately as the sooner you begin treatment, the sooner you will experience relief.
Occasionally your plantar fascia can snap and you could hear a clicking or snapping sound, accompanied by swelling, intense pain and significant swelling. You need to see a doctor urgently if this occurs.
Physiotherapy & Treatment Options
Your physiotherapist will assess the extent of your injury, and will explore the causes of your injury.
Depending on your symptoms, you may have the soles of your feet taped or strapped to support your feet and reduce pain. You may also need to wear a plantar fasciitis brace or heel cups in the initial stages of healing.

Your physiotherapist will take you through a number of gentle stretching exercises for your feet, as well as exercises to address any tight Achilles tendons or calf muscles.
We will combine these with pain reduction techniques that you can do at home such as rolling your foot on a frozen water bottle or frozen golf ball to help ice your injury site.
Massage, joint mobilisation techniques, dry needling and ultrasound therapy will also be used to reduce swelling and restore movement.

For your footwear, we recommend you replace your joggers every 650km of use, and only wear shoes that support your feet while healing. Definitely no thongs or slides!
It also helps to put your shoes on first thing in the morning, before you take your first steps. Avoid barefoot walking on tiles or hard surfaces while you heal.
If the cause of your injury is your feet shape or foot pronation, you may need special orthotics. If this is indicated, we would conduct a walk/run assessment on you and have your technique analysed.

To maintain your fitness during your treatment, we recommend swimming and cycling. Don’t return to running until you have been pain free for at least one week, and then only run on soft surfaces until you rebuild your strength and stamina. If pain is felt at any time, then go back to swimming and cycling rather than running.
Unfortunately, Plantar Fasciitis is a long-term injury, and may take a number of months to fully heal even with the most aggressive treatments.

Things to Remember
Plantar Fasciitis is the most common cause of heel and arch pain, and is caused by micro tears to the plantar fascia.
It is a gradual onset injury and causes sharp pain when taking the first few steps in the morning or after rest.
Physiotherapy can treat plantar fasciitis, while reducing pain and increasing movement during healing.
Your physiotherapist may advise you of techniques for the improvement of your walk/running style, or provide you with solutions for arch support, to help prevent further reoccurrence.
Healing may take many months for full recovery.

More

Foot Orthotic benefits

Foot Orthotic benefits

The impact of custom semirigid foot orthotics on pain and disability for individuals with plantar fasciitis.

Source: J Orthop Sports Phys Ther. 2002 Apr;32(4):149-57.

Division of Physical Therapy, Program in Human Movement Science, University of North Carolina at Chapel Hill, 27599-7135, USA. mtgross@med.unc.edu

Abstract

STUDY DESIGN:

Single-group, pre-, and post intervention repeated measures design.

OBJECTIVE:

To determine the impact of custom semi rigid foot orthotics on pain and disability for individuals with plantar fasciitis.

BACKGROUND:

Few studies have examined the efficacy of foot orthotics for plantar fasciitis, and no single study has yet examined the effects of semirigid foot orthotics on an established quality-of-life instrument.

METHODS AND MEASURES:

Eight men and 7 women (mean ages 44.7 +/- 9.0 years) who reported having plantar fasciitis symptoms for an average of 21.3 +/- 23.7 months participated in the study. Subjects were timed for a 100-m walk at a self-selected speed, then they rated the pain they experienced during the walk using a 10-cm visual analog scale. Subjects also completed the pain and disability subsections of the Foot Function Index questionnaire. All measures were acquired before the fabrication of custom semirigid foot orthotics and 12 to 17 days following onset of foot orthotic use.

RESULTS:

Postorthotic 100-m walk times were not significantly different (t = 0.39, P = 0.70) than preorthotic values. Postorthotic pain ratings (mean = 0.7 +/- 0.7) for the 100-m walk were significantly less than (Wilcoxon t = 1, P < 0.005) preorthotic pain ratings (mean = 3.0 +/- 1.7). Postorthotic Foot Function Index pain subsection ratings (Wilcoxon t = 0, P < 0.005) were significantly less than preorthotic ratings, demonstrating a 66% reduction in pain ratings. Postorthotic Foot Function Index disability subsection ratings (Wilcoxon t = 0, P < 0.005) were significantly less than preorthotic ratings, demonstrating a 75% reduction in disability ratings.

CONCLUSION:

Custom semirigid foot orthotics may significantly reduce pain experienced during walking and may reduce more global measures of pain and disability for patients with chronic plantar fasciitis.

More

Foot Orthotics

Foot Orthotics

When standing and walking, we are subjected to forces that produce stress and strain throughout our bodies. When a foot imbalance is present there can be abnormal forces on the feet, knees, hips, back and/or neck that lead to pain and poor function. The foot imbalance must be corrected to improve body alignment and therefore, decrease pain and improve function.

What are Custom Orthotics?

Custom orthotics are devices which are inserted into footwear to support or correct your foot function.

When appropriately prescribed, custom orthotics can:

  • Decrease pain, not only in the foot, but in other parts of the body such as the knee, hip and lower back.
  • Increase stability in an unstable joint.
  • Prevent a deformed foot from developing additional problems.
  • Improve overall quality of life.

How are custom orthotics made?

While orthotics can be made by several different processes, we take a foam impression of the patient’s foot in a “neutral” position and send it to a laboratory with the physiotherapist’s direction for correction.

At the lab, technicians pour plaster into the mould and, when it hardens, it reproduces the bottom of the individual’s foot. The technicians then use the physiotherapist’s directions to custom-make a device to meet the patient’s specific needs.

Who Can Benefit From Orthotics?

  • those in need of relief of painful foot problems or an injury
  • people who must walk or stand excessively on the job
  • those who are active in sports: orthotics will often increase endurance, performance and strength
  • overweight individuals: orthotics can help to counteract the extra stress on the feet, as minor problems are often magnified due to the increased weight
  • older adults who may have developed arthritis in their feet: orthotics are particularly effective in relieving foot fatigue and discomfort
  • orthotics may also be prescribed for children who have a foot deformity

Types of Custom Orthotics

Different types of custom orthotics are available for different uses. There are a number of sport specific orthotics designed for use in running/walking shoes, ski boots, skates, golf shoes and court shoes. Sandals come with the orthotic built in a way to prevent slippage. Dress shoes generally don’t have much extra space and therefore come with a thinner orthotic. There are also orthotics designed for special health needs such as arthritis and diabetes. Talk to us about what type of custom orthotic would best suit your needs!

 

More