Plantar Fasciitis – Heel Pain
Feet are an area of the body that some of us neglect and forget until they start to hurt. Considering the fact that the foot is the main point of contact to the ground and the many miles we must walk in a life time, they are an area that we should look after. In our Osteopathic surgery we see all sorts of different types of feet and we often assess a patient’s foot even if the problem is somewhere else as the way the foot contacts the ground when walking can have profound affects elsewhere in the body.
The planter fascia is a tight band that stretches across the bottom of the foot from the heel to the base of the toes, connecting the two ends of the arch of the foot. When we walk it acts like the string of a bow, so when it is stretched in the mid-stance of walking it then recoils to provide propulsion at toe off. All the bones along with the ligaments that hold them together and the muscles that move and support them form a complex structure allowing us to deal with the different activities and surfaces we encounter. In fact the foot was designed to deal with surfaces such as mud and sand, not the hard man-made surfaces we walk on today. Therefore we have to wear some form of protective covering on our feet to absorb shock. It is these hard surfaces and incorrect footwear that could be blamed for causing various types of foot pain.
Plantar fasciitis is becoming a more common problem we see in the clinic, and is often caused by prolonged standing and walking, incorrect footwear and poor foot function. It occurs because small tears appear where the plantar fascia attaches to the bone, causing inflammation. The attachment of the fascia to the calcaneum (heel) can then occasionally calcify causing a heel spur. The pain can be sharp or achy and is normally located on either side of the heel, and under the arch of the foot. It is often worse in the morning and can cause some people to limp, it may also ache at night. The pain can worsen during the day if standing for long periods or walking distances.
The condition can respond well to rest, but this is normally unrealistic in most people’s lives. Therefore correct footwear is essential, it should be cushioned and have some form of arch support. A lot of footwear we use today does not have the adequate support. Depending on your needs, age and foot type will affect what footwear is best. For example long distance running, working on your feet all day as a hairdresser or nurse, working in a factory etc. will all require different support and cushioning.
Various home stretching exercises to the lower extremity can help to relieve tension in the foot. Anti-inflammatory medication can help to reduce the pain, but will not cure the problem.
If your plantar fasciitis is not resolving then the next step is to seek some help. As Osteopaths, we are qualified to:
Fully assess the biomechanics of your gait (walking) and foot function.
Look at your posture and how it may be contributing to the problem.
Give advice on both footwear and orthotics/insoles.
Provide treatment to loosen up the relevant muscles and improve the function of the joints of the lower extremity.
Provide lifestyle advice, which may help in combating the problem.