Plantar Fasciitis - How A Chiropodist Can Help
- Do you have a stabbing pain in the bottom of your foot near the heel?
- Does it happen when you first step out of bed in the morning?
- Does it happen after long periods of standing or rising from sitting?
- Is the pain worse after exercising or running?
The most common cause of heel pain is plantar fasciitis. It involves inflammation of a thick band of tissue that runs across the bottom of your foot and connects your heel bone to your toes (plantar fascia).
It is important to have the cause of your heel pain accurately assessed because there are many causes of heel pain. These can include: heel spurs, stress fractures, bursitis, tendonitis, arthritis, nerve irritation, nerve entrapment or cysts.
As a professional chiropodist and foot specialist, I am able to distinguish between all the possibilities and determine the underlying source of your heel pain. I’ll then recommend the most effective treatment plan for you.
What is plantar fasciitis?
The plantar fascia is a fibrous band of tissue that runs along the bottom of the foot, from the heel to the ball of the foot. It is a non-elastic tissue that typically will not stretch.
Over-extending this tissue, as in cases of “flat feet”, or excess stress on the fascia (such as from standing on hard surfaces for long periods of time), can result in irritation and tears. When the plantar fascia becomes irritated, this results in pain and inflammation.
Typically the most common area of pain is at the weakest link, where the fascia inserts into the heel, but pain may occur anywhere along the length of the tissue.
What does plantar fasciitis feel like?
- Pain on the bottom of the heel
- Pain in the arch of the foot
- Pain that is usually worse in the morning or after rest
- Pain that increases over a period of months
What causes plantar fasciitis?
The most common cause of plantar fasciitis relates to faulty structure of the foot. For example, people who have problems with their arches, either overly flat feet or high-arched feet, are more prone to developing plantar fasciitis.
Certain activities that put increased weight and forces through the feet, such as running and jumping can also be a pre-cursor to plantar fasciitis. Wearing non-supportive footwear on hard, flat surfaces can also put abnormal strain on the plantar fascia. This is particularly evident when one’s job requires standing for long hours at a time. Obesity may also contribute to plantar fasciitis.
Treatment of plantar fasciitis?
First line treatment of plantar fasciitis begins with conservative options.
- Stretching exercises – Stretch out the calf muscles at the back of the calf help ease pain and promote better foot function. Tight muscles can cause the foot to over-compensate and put extra stress on soft tissues.
- Wear shoes – When you walk without shoes, you put extra stress on your plantar fascia. This means wearing good supportive shoes at home as well.
- Wear good shoes – Wearing supportive shoes that have good arch support and a slightly raised heel reduces stress on the plantar fascia.
- Ice – Putting an ice pack on your heel for 20 minutes several times a day helps reduce inflammation. An even better option is rolling your foot on a frozen water bottle. This not only helps with the pain and inflammation but also helps to strengthen the small muscles of the foot that prevent your arch from collapsing.
- Padding – A gel heel insert or gel cushion in your shoe will give extra cushion and may help to take the sting out of your steps.
- Limit activities – Cut down on extended physical activities to give your heel a rest.
- Medications – Anti-inflammatory drugs such as ibuprofen or naproxen may be recommended to reduce pain and inflammation.
If you still have pain after several weeks, or if it went away but came back, you may likely need more intensive assessment and treatment. A chiropodist and foot specialist can determine which or all of the following therapies should be added to your treatment plan.
- Orthotics – Custom orthotic devices that fit into your shoe help correct the underlying structural abnormalities causing the plantar fasciitis. Often even with the best medication, exercises and physical therapies, if you do not address the root cause of the problem, the pain will keep coming back.
- Medication – When over the counter medications do not provide sufficient relief, prescription strength medications may be added to your treatment plan.
- Physical therapy – Treatments such as laser, ultrasound and shockwave therapy are often successful in alleviating stubborn symptoms.
- Corticosteroids – In some cases, corticosteroid injections are used to help reduce inflammation and relieve pain.
- Removable walking/air cast – A removable walking cast may be used to keep your foot immobile for a few weeks to allow it to rest and heal in severe cases.
- Night splint – Wearing a night splint allows you to maintain an extended stretch of the plantar fascia while sleeping. This may help reduce the morning pain experienced by some patients.
Do I need surgery for plantar fasciitis?
In the large majority of cases, surgery is not considered. Most people with plantar fasciitis respond well to non-surgical conservative treatments. However, a very small percentage of patients may benefit from surgery.
Long-term management of plantar fasciitis
No matter what your treatment for plantar fasciitis involves, the underlying causes that led to this condition may remain. People often forget the pain and the treatment once they feel better. But if the causes are not addressed, the pain and symptoms are almost guaranteed to recur.
It is so important to continue with preventive measures. Supportive and stable shoes, proper stretching and strengthening exercises, as well as wearing custom orthotics to control foot function are the cornerstones of long-term treatment and prevention of plantar fasciitis.
I am a registered chiropodist and foot care specialist and have been helping patients for over 20 years.
There are 600 registered chiropodists in Ontario and only 60 podiatrists. Chiropodists and podiatrists provide the same care.
Chiropodists today must complete 7 years of post-secondary education. We do complete case management of foot problems, assessing and treating the entire foot and its complications.
Chiropodist Trina Scarrow, BSc, DCh treating a patient with foot pain — for proper foot functioning and overall well-being.
I provide full biomechanical exams and gait analysis — I will be able to help address your foot discomfort by foot care treatment, custom orthotics and orthopaedic shoes, surgery, medication, laser or physical therapy.
Chiropodists and podiatrists are the only regulated health professions who have the ability to prescribe and provide custom orthotics as defined in the Regulated Health Profession Act of Ontario.
I want to help get your feet functioning better so you can feel better.