Heal Pain when walking – Plantar Fasciitis treatment
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 fasica 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.
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.
Signs & Symptoms of Plantar Fasciitis
When commencing walking immediately after sitting down for a prolonged period.
Pain experienced when walking, running or standing.
Heel pain and stiffness when getting out of bed in the morning time. Pain may begin to disappear after a short walk to the kitchen.
Numbness can sometimes be felt along the outside of the sole of the foot
Tenderness and even swelling can be felt on the inside of the heel bone that touches the ground (calcaneal bone)
Calf muscles and achilles tendon is commonly tight
In some cases of Plantar Fasciitis, a heel spur is present underneath the heel bone.
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 treatment of this condition. When patients attend my clinic with Plantar Fasciitis, the treatment plan always includes stretching techniques to the plantar fascia muscles in order to relieve the taut pull on its insertion point to the heel bone. Stretching of the tight calf muscles and Achilles tendon is also carried out so that foot biomechanics improve. A Gel Heel Cup is always a useful addition to the healing process. Finally instructions on graded strengthening exercises 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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