Heal Pain when walking – Plantar Fasciitis treatment
July 19, 2016
Plantar Fasciitis is a very common condition that causes a stabbing pain underneath the heel of the foot. The pain is mainly experienced by patients whose occupation involves standing and walking. Indeed the stabbing pain is aggravated by walking, running and even climbing of stairs. The condition is brought about when micro tears appear on the plantar fascia tendon sheath (see illustration) attaching to the heel bone (calcaneal bone). This plantar fascia sheath connects the heel bone to the toes and is constantly stretched during walking and running when the heel is lifted off the ground during foot movement. When the toes touch the ground during walking, the plantar fascia sheath is stretched. If the plantar fascia is very tight, micro tears followed by inflammation can occur at its attachment point underneath the heel bone.
The main symptom of Plantar Fasciitis is sharp pain underneath the heel of the foot when commencing walking after sitting down for a prolonged period. Pain can often disappear after a few steps; more chronic plantar fascia persists even with walking. Patients commonly report pain when getting out of bed in morning time.
Causes of Plantar Fasciitis include:
Excessive falling inwards of the foot during walking (over pronation) causing an over repetitive pull on plantar fascia attachment point to the heel bone.
High arch feet can result in excessive stress to the plantar fascia due to the lack foot pronation.
Prolonged wearing of shoes that do not provide adequate support to the arch of the foot.
Treatment & Management of Plantar Fasciitis
The application of ice to the heel and avoidance of aggravating activities such as long distance walking is essential for the early stage treatment of this condition. When patients attend my clinic with Plantar Fasciitis, the treatment process includes targeting the belly of the plantar fascia muscles in order to relieve the taut pull on its insertion point to the heel bone. In addition ultrasound in the early stage followed by graded friction coupled with ice after the acute stage is important. Stretching of the tight calf muscles and Achilles tendon is also carried out so that foot biomechanics improve. Hard Insole orthothics should be replaced with a more flexible material. An orthotic with a Gel Heel Cup is always a useful addition to the healing process. Finally instructions on graded strengthening exercises for the medial arch of the foot and for the plantar fascia muscle are essential for full recovery.
Tomás Ryan is a Registered Physical Therapist with The Irish Association of Physical Therapy and is based in Thurles.
Contact Number: 0504 26672
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