Plantar Fasciitis
How do you get plantar fasciitis?
Plantar fasciitis is caused by either a traction or compression injury.
Traction plantar fasciitis is a biomechanical problem and is generally an overuse injury that has a gradual worsening of symtoms over time. The plantar fascia is repeatedly overstretched until it loses its elastic recall.
Compression type plantar fascia injuries have a traumatic history. Landing on a sharp object that bruises your plantar fascia is your most likely trauma.
The location of plantar fasciitis pain will be further under your arch than under your heel, which is more likely to be a fat pad contusion if a single trauma caused your pain. The compression type plantar fasciitis can confused with a fat pad contusion that is often described as a "stone bruise".
What are the symptoms of plantar fasciitis?
Typically you will notice pain in your arch or heel when you wake in the morning or post exercise.
It will generally get better as you warm up. From there it generally starts progressing
You'll typically first notice early plantar fasciitis pain under your heel or in your foot arch in the morning or after resting.
Your heel pain will be worse with the first steps and improves with activity as it warms up.
Plantar fasciitis generally progresses as follows
Ultimately, further trauma and delayed healing will result in the formation of calcium (bone) within the plantar fascia. When this occurs adjacent to the heel bone it is known as heel spurs, which have a longer rehabilitation period.
It will generally get better as you warm up. From there it generally starts progressing
You'll typically first notice early plantar fasciitis pain under your heel or in your foot arch in the morning or after resting.
Your heel pain will be worse with the first steps and improves with activity as it warms up.
Plantar fasciitis generally progresses as follows
- Pain on waking
- Pain after exercise and 1
- Pain before exercise, 1 and 2.
- Pain during exercise, 1,2 and 3.
- Pain all the time including at rest
Ultimately, further trauma and delayed healing will result in the formation of calcium (bone) within the plantar fascia. When this occurs adjacent to the heel bone it is known as heel spurs, which have a longer rehabilitation period.
How do you help plantar fasciitis?
Plantar fasciitis is generally very successfully treated and is mostly fully reversible. About 90 percent of people with plantar fasciitis improve significantly within two months of initial treatment. Plantar fasciitis is treated conservatively by a physiotherapy and if this stalls at the 3-6 week mark Extracorporeal shock wave therapy ESWT is then started.
Should I get a cortisone injection if my heel hurts?
If your plantar fasciitis continues after a few months of conservative treatment, your doctor may suggest to inject your heel with steroidal anti-inflammatory medications (corticosteroid). Cortisone injections have been shown to have short-term benefits but they actually retard your progress in the medium to long-term, which usually means that you will suffer recurrent bouts for longer.
Due to poor foot biomechanics being the primary cause of your plantar fasciitis it is vital to thoroughly assess and correct your foot and leg biomechanics to prevent future plantar fasciitis episodes or the development of a heel spur.
Your physiotherapist is an expert in foot assessment and its dynamic biomechanical correction. They may recommend one of many treatment courses depending on your history, level of pain and response to treatment.
Should I get a cortisone injection if my heel hurts?
If your plantar fasciitis continues after a few months of conservative treatment, your doctor may suggest to inject your heel with steroidal anti-inflammatory medications (corticosteroid). Cortisone injections have been shown to have short-term benefits but they actually retard your progress in the medium to long-term, which usually means that you will suffer recurrent bouts for longer.
Due to poor foot biomechanics being the primary cause of your plantar fasciitis it is vital to thoroughly assess and correct your foot and leg biomechanics to prevent future plantar fasciitis episodes or the development of a heel spur.
Your physiotherapist is an expert in foot assessment and its dynamic biomechanical correction. They may recommend one of many treatment courses depending on your history, level of pain and response to treatment.
How do I get better?
Contact us on 5547 5666 to schedule an assessment
or
Click here to find out more about our physiotherapy services
or
Click here to meet our team
or
Click here to find out more about our physiotherapy services
or
Click here to meet our team
References
- Gollwitzer H, Diehl P, von Korff A, Rahlfs VW, Gerdesmeyer L. Extracorporeal shock wave therapy for chronic painful heel syndrome: a prospective, double blind, randomized trial assessing the efficacy of a new electromagnetic shock wave device. J Foot Ankle Surg 2007;46:348-57.
- Gerdesmeyer L, Frey C, Vester J, et al. Radial extracorporeal shock wave therapy is safe and effective in the treatment of chronic recalcitrant plantar fasciitis: results of a confirmatory randomized placebo-controlled multicenter study. Am J Sports Med 2008;36: 2100-9.
- Ibrahim MI, Donatelli RA, Schmitz C, Hellman MA, Buxbaum F. Chronic plantar fasciitis treated with two sessions of radial extracorporeal shock wave therapy. Foot Ankle Int 2010;31:391-7.
- Marks W, Jackiewicz A, Witkowski Z, Kot J, Deja W, Lasek J. Extracorporeal shock-wave therapy (ESWT) with a new-generation pneumatic device in the treatment of heel pain. A double blind randomised controlled trial. Acta Orthop Belg 2008;74:98-101.
- Radwan YA, Mansour AM, Badawy WS. Resistant plantar fasciopathy: shock wave versus endoscopic plantar fascial release. Int Orthop 2012;36:2147-56.
- Rompe JD, Decking J, Schoellner C, Nafe B. Shock wave application for chronic plantar fasciitis in running athletes. A prospective, randomized, placebo-controlled trial. Am J Sports Med 2003;31:268-75.
- Speed CA, Nichols D, Wies J, et al. Extracorporeal shock wave therapy for plantar fasciitis. A double blind randomised controlled trial. J Orthop Res 2003;21:937-40.
- Judy A David, Venkatesan Sankarapandian, Prince RH Christopher, Ahana Chatterjee, Ashish S Macaden. Injected corticosteroids for treating plantar heel pain in adults http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD009348.pub2/full
