Are you trying to deal with heel pain and plantar fasciitis? Is it negatively impacting your life? Are you looking for relief? If so, this blog is for you! In this second part of our series, we discuss the prevention and treatment of plantar fasciitis. Read Part 1 here.
How To Look After Plantar Fasciitis At Home
These are some tips to ease the discomfort associated with plantar fasciitis.
Reduce activity level - this is advised in the short-term to reduce the tenderness. Limit activities such as running, jumping or dancing.
Avoid walking barefoot - barefoot walking permits shock to radiate through the feet, which can aggravate plantar fasciitis.
Wear appropriate footwear - avoid non-supportive shoes made from soft materials such as fabric, canvas etc.
Check the heel counter of the shoe (the little plastic insert in the heel) to make sure it is sturdy and does not easily collapse.
Check the flexibility of the sole; the only area of flexibility should be at the big toe joint for propulsion when walking. Ideally wear runners which have cushioning and are a good fit. Brands of shoes which are recommended include Asics, Brooks, New Balance, ECCO.
Use gel heel cups - these are available from most pharmacies and can offer some shock absorption in the short-term.
Apply ice - regular application of ice may help reduce swelling.
Non-steroidal anti-inflammatory drugs (NSAIDs) - over-the-counter nonsteroidal anti-inflammatory medications, such as ibuprofen, can reduce swelling and relieve pain. However, you should talk to your doctor or pharmacist before taking any medication.
Management Of Plantar Fasciitis
Reducing the discomfort caused by the inflammation of the plantar fascia ligament is an important step in managing this condition, but this doesn’t address the cause of the damage to the ligament.
It is important to treat this condition in the early stages. Plantar fasciitis occurs in the first 6 weeks of discomfort and pain as it is an acute inflammation. After 6 weeks, it becomes chronic and is called plantar fasciopathy, which is much more difficult to treat. The treatment depends on the severity of the symptoms. The longer the condition has been present the longer it can take to reduce the pain. Your doctor or podiatrist will likely recommend trying conservative approaches first.
What Can A Podiatrist Do For Me?
The podiatrist will perform a full biomechanical assessment, where they take a full history and assess both your footwear and the way you walk. It is a good idea to bring in 2 to 3 pairs of the shoes you wear the most often to the appointment so your podiatrist can get a better picture and ultimately a more accurate diagnosis. To know what to expect during the assessment, have a read of our blog here.
The podiatrist will identify the likely cause of the plantar fasciitis and help you find ways to prevent it from recurring, which is very common. Spectrum Health podiatrists have extensive experience in the treatment of plantar fasciitis and other heel pain conditions.
What Are The Most Common Treatments?
Stretch and strengthen - a podiatrist may demonstrate and explain an exercise programme to stretch and to strengthen the plantar fascia, achilles tendon, as well as the calf muscles. This is usually very effective and is typically a 6 week stretching regime.
Taping and strapping - this can reduce strain and provide support to the plantar fascia. This treatment may be used in very acute conditions. However, the tape only lasts a few days. The podiatrist may teach you to apply athletic taping to support the bottom of your foot.
Night splint - this is another treatment method which may help stretch the arch of the foot and the calf muscles. It is a type of brace that keeps the foot in a flexed position and aims to lengthen the plantar fascia and achilles tendon overnight. This may prevent pain during the first few steps in the morning.
Footwear advice - podiatrists can advise on appropriate footwear properties, especially for those who are considering orthotic therapy. Footwear must have a removable foot-bed (inner/insole) which is taken out and replaced with an arch support. Placing an arch support on top of an existing foot-bed can cause other problems such as corns, hammer toes, restriction in circulation due to lack of space, friction and blisters.
Orthotics - insoles alleviate pain by distributing pressure more evenly. They offload and prevent further damage to the plantar fascia by tilting and realigning the body, limiting the inward roll (pronation or fallen arch) or outward roll (supination). There are two different forms of insoles:
Over the counter (OTC) insoles - these are generic arch supports which can reduce pressure on the feet. Some are neutral and some have an in-built correction. Others have an option to attach correction, which can be varied if more correction is needed on one side of the foot. These insoles generally cost between €45 and €75 from Spectrum Health and will be chosen to best suit your needs and footwear.
Custom made insoles - these are insoles which are customised, tailor-made for an individual. They can be altered as needed and are the best long term treatment option for plantar fasciitis.
What Other Treatments Are Available?
Shockwave therapy - if the pain continues and other methods are not working; your podiatrist may recommend this new, high-tech treatment. Shockwaves are passed through the affected tissue to stimulate healing. This is only available in selected Spectrum Health clinics, so please request this when booking. Read more on shockwave therapy here.
Steroid injection - if conservative treatments are not successful, an injection of a corticosteroid directly into the damaged area may be advised. However, steroid injections have side effects, can weaken the plantar fascia and cause potential rupture. As a steroid injection treats the symptoms, not the cause of the plantar fasciitis, the pain may reoccur.
Surgery - this is only performed in very severe cases, where all other treatment options have failed.
References
- Mayo Clinic. 2020. Plantar Fasciitis - Symptoms And Causes. [online] Available at: