- Provide strapping which can often relieve symptoms instantly as it off loads the fascia
- Offer orthotics if necessary, depending on the stage and mechanism of injury to off load and prevent the injury from worsening
- Refer you to a physiotherapist for massage and strengthening exercises.
- Educate you on how to rehabilitate the injury effectively.
- Orthotic Consultation for treatment and prevention of plantar fasciitis may be arranged by our trained clinical team
You’re at a greater risk of developing plantar fasciitis if you’re overweight or obese due to the increased pressure on your plantar fascia ligaments, especially if you have sudden weight gain. Pregnant women often experience bouts of plantar fasciitis, particularly during late pregnancy.
If you’re a long-distance runner, you may likely develop plantar fascia problems. You’re also at risk if you have a very active job that often involves being on your feet, such as a factory worker or restaurant server. Active people 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.
You may develop plantar fasciitis if you have foot problems, such as very high arches or very flat feet. Tight Achilles tendons, which are the tendons attaching your calf muscles to your heels, may also result in plantar fascia pain. Simply wearing shoes with soft soles and poor arch support can also result in plantar fasciitis.
Plantar fasciitis isn’t typically the result of heel spurs. A heel spur is a hook of bone that can form on the heel bone, or calcaneus, of the foot. According to the American Association of Orthopaedic Surgeons (AAOS), one out of every 10 people has a heel spur, but only one out of 20 people with heel spurs experience pain.
Initial home treatment includes staying off your feet and applying ice for 15 to 20 minutes, three or four times daily to reduce swelling. You can also try reducing or changing your exercise activities.
Using a foot orthotic or “arch support” in your shoes and stretching exercises may also help relieve pain. This is where an orthotic/biomechanical assessment may improve your symptoms considerably.
The symptoms may resolve if treated in the acute phase (soon after symptoms are experienced, usually suggested within three months) rather than in a chronic state (long term). There is an orthotic solution to suit all requirements, be it a fully custom insole, semi-custom, or off-the-shelf version. Some orthotics aid your stretching and exercise program, which may include a night stretching AFO or a Strassberg sock.
If home treatments and over-the-counter anti-inflammatory drugs don’t ease the pain, an injection of a corticosteroid directly into the damaged section of the ligament can help. Your doctor can do this in their office, and your doctor may use an ultrasound device to help determine the best place for the injection. Your doctor can also apply corticosteroids to the skin of your heel or the arch of your foot and then apply a painless electrical current to let the steroid pass through your skin and into the muscle.
Physiotherapy is an integral part of the treatment for plantar fasciitis, and it can help stretch your plantar fascia and Achilles tendons. A physiotherapist can also show you exercises to strengthen your lower leg muscles, helping to stabilize your walk and lessen the workload on your plantar fascia. Our colleagues at Rope Therapy can help you with a program should the symptoms become chronic and keep you on track along with your orthotic treatment plan.
If pain continues and other methods aren’t working, your doctor may recommend extracorporeal shock wave therapy. This treatment is now being used in New Zealand amongst specialist podiatrist. In this therapy, sound waves bombard your heel to stimulate healing within the ligament. This treatment can result in:
- bruises
- swelling
- pain
- numbness
It hasn’t been proven to be consistently effective in relieving symptoms.
The most dramatic therapy, used only in cases in which pain is very severe, is surgery. Your surgeon can partially detach the plantar fascia from the heel bone, but this weakens the arch of the foot and full function may be lost. Another surgery involves lengthening the calf muscle. This process is called gastrocnemius recession.
Night splints are another treatment that can help stretch your calf and the arch of your foot. Night splints are a type of brace that holds your foot in a flexed position and lengthens the plantar fascia and Achilles tendon overnight and can prevent morning pain and stiffness.
Special orthotics, or arch supports, for your shoes may help alleviate some of the pain by distributing pressure, and they can prevent further damage to the plantar fascia. A boot cast or Moonboot may immobilize your foot and reduce strain while the plantar fascia heals. You can remove the boot cast or Moonboot, which looks like a ski boot, for bathing.
You can develop chronic heel pain if you ignore the condition, and can change the way you walk and cause injury to your:
Steroid injections and other treatments can weaken the plantar fascia ligament and cause potential ligament rupture.
Surgery carries the risks of bleeding, infection, and reactions to anaesthesia. Plantar fascia detachment can also cause changes in your foot and nerve damage, and gastrocnemius resection can also cause nerve damage.
Most people don’t need surgery to relieve pain from plantar fasciitis. Instead, their condition improves through physical therapy, home and medical treatments. However, treatment can take several months to two years to improve your symptoms.
What are some ways an overweight or obese person with plantar fasciitis can exercise to alleviate their symptoms without experiencing more pain?
While it’s typical to experience pain in just one foot, massage and stretch both feet. Do it first thing in the morning and three times during the day.
Here are great exercises that you can do:
- Achilles Tendon Stretch: Stand with your affected foot behind your healthy one. Point the toes of the back foot toward the heel of the front foot and lean into a wall. Bend the front knee and keep the back knee straight with your heel firmly planted on the floor. Hold for a count of 10.
- Plantar Fascia Stretch: Sit down and place the affected foot across your knee. Using the hand on your affected side, pull your toes back toward your shin until you feel a stretch in your arch. Run your thumb along your foot. You should feel tension. Hold for a count of 10.
- Swimming or Other Water Sports: These exercises place no direct impact on your heels, and water therapy can help reduce the inflammation caused by plantar fasciitis.