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Nothing can disrupt normal daily living quite as much as pain that keeps you from moving around.
If you’re experiencing pain in the bottom of your heel, it may be worth getting it checked out. Your plantar fascia ligament may be inflamed, which could be causing your pain.
What is plantar fasciitis?
Plantar fasciitis causes pain in the bottom of the heel. The plantar fascia is a thick, weblike ligament that connects your heel to the front of your foot. It acts as a shock absorber and supports the arch of your foot, helping you walk.
Plantar fasciitis is one of the most common orthopaedic complaints. The plantar fascia can become painful as a result of excessive load, incorrect footwear, a foot injury, prolonged rest for instance after a fracture of the lower limb or through progressive failure of the tissue in itself. The plantar fascia becomes inflamed, and the inflammation causes heel pain and stiffness.
What are the primary symptoms of plantar fasciitis?
The major complaint of those with plantar fasciitis is pain at the bottom of the heel or sometimes at the bottom mid-foot area. It usually affects just one foot, but it can affect both feet.
Pain from plantar fasciitis develops gradually over time. The pain can be dull or sharp. Some people feel a burning or ache on the bottom of the foot extending outward from the heel.
The pain is usually worse in the morning when you take your first steps out of bed, or if you’ve been sitting or lying down for a while. Climbing stairs can be very difficult due to heel stiffness.
After prolonged activity, the pain can flare up due to increased irritation or inflammation. People with plantar fasciitis don’t usually feel pain during the activity, but rather just after stopping.
What causes plantar fasciitis and who gets it?
Plantar fasciitis tends to develop as a result of overstretching or overuse of this ligament, although a tear or small tears in the fascia tissue can also cause the pain. Your foot structure can also predispose you to developing plantar fasciitis.
Active men and women between the ages of 40 and 70 are at the highest risk for developing plantar fasciitis. It’s also slightly more common in women than men. Women who are pregnant often experience bouts of plantar fasciitis, particularly during late pregnancy.
You’re at a greater risk of developing plantar fasciitis if you:
- are overweight or have obesity. This is due to the increased pressure on your plantar fascia ligaments, especially if you have sudden weight gain.
- are a long-distance runner.
- have an active job where you are often on your feet
- have structural foot issues, such as high arches or flat feet.
- have tight Achilles tendons, which are the tendons attaching your calf muscles to your heels.
- often wear shoes with soft soles and poor arch support.
How can we diagnose plantar fasciitis?
Your practitioner will perform a physical exam to check for tenderness in your foot and the exact location of the pain. This is to make sure that the pain isn’t the result of a different foot problem.
During the evaluation, they may ask you to flex your foot while they push on the plantar fascia to see if the pain gets worse as you flex and better as you point your toe. They’ll also note if you have mild redness or swelling.
As our feet ultimately support our whole body it is also important to evaluate the strength in the whole lower limb and core muscles as weaknesses higher ‘up the chain’ may contribute to your heel pain.
How is plantar fasciitis treated?
Home treatments like rest, icing and anti-inflammatory drugs are often the first ways to treat plantar fasciitis. If these basic self help measures have no effect then your best option is to come along to be assessed and have a treatment plan put together for you which could include Shockwave Therapy and a prescribed exercise programme.
If pain continues and other methods aren’t working, extracorporeal shock wave therapy can solve the pain issue. In this therapy, sound waves bombard your heel to stimulate healing within the ligament. We have found approx. a 70% success rate with treating plantar fasciitis with ESWT.
Specific exercises and stretches can help relieve your heel pain. Stretching your calves and the plantar fascia itself helps loosen your muscles and reduce heel pain.
It’s important to take time off from certain exercises, like running, to give the plantar fascia time to heal. Swimming and other low-impact activities can let you exercise without worsening your heel pain. When you start running again, be sure to begin slowly.
How long does it take to recover from plantar fasciitis?
For most people, plantar fasciitis improves within a few months of treatments, especially when following the advice and treatment plan from a specialist practitioner.
How can you prevent plantar fasciitis?
Making a few lifestyle changes may help you avoid plantar fasciitis.
Wear supportive shoes with good arch support, and replace your athletic footwear regularly. If you’re a runner, around 400 to 500 miles is the limit for each pair of shoes before you should buy new ones.
Incorporate low-impact exercises into your routine, like swimming or bicycling. Avoid overworking your plantar fascia with very frequent running. Before exercising, be sure to stretch your calves, Achilles tendon, and plantar fascia.
Do your best to stay at a healthy weight. If you’re overweight, try to lose weight to reduce pressure on your plantar fascia.
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