Get the right advice for plantar fascia and achilles tendinitis pain.

Star Physio’s Dr James Debenham (PhD) assessing achilles tendonitis and plantar fascia pain.

Top Tips for Managing Plantar Fasciitis- The dos and don’ts!

Plantar Fasciitis, or heel spurs is broadly described as pain in the rear of the underside of the foot. It is typically described as an overuse injury, although our expert physiotherapists at Star Physio would prefer to describe it as an “under-prepared injury” where an individual has taken on a task or exercise beyond their capacity. This often leads to an initial period of inflammation but usually is characterised by degeneration of  the plantar fascia tissue which requires careful rehabilitation by physiotherapists using current evidence for a successful long term outcome. It is commonly seen in runners or triathletes who have too greater increase in their training load and it is particularly common in females around the period of menopause.

Sadly there are many health professionals, including well known physiotherapists, who are advertising and providing disproven and outdated forms of treatment for this common problem. Read Star Physio’s tips to help guide you through the minefield of rubbish treatments being provided to help you chose the right physiotherapist to get you back on track quickly!

At Star Physio, we are fortunate to have world leading researchers and experts in tendon pain on staff to make sure you get the best, and most up to date treatment and advice available. Google the latest research around tendon pain and you will be sure to find the names of a few of our physios there! No snake oil or disproven treatment, just the best possible care to have you back doing what you love to do as quickly as possible. Check out our team here http://starphysiowa.com.au/about/our-team/ 

Our expert team are available at one of our three locations in West Perth, Hay St Mall-Perth CBD and Mosman Park. See this link for clinic location maps. http://starphysiowa.com.au/contact-us/

Sometimes scans or x-rays will show microtearing in the fascia or a bony spur or prominence in the area but these may not be related to the pain. In nearly every case, there is no justification to get X-Rays or other scans as the results are unlikely to change the way the a good physiotherapist will manage your injury.

Don’t!

  • Stretch your sore plantar fascia! Plantar Fasciitis, or fasciosis as it is probably better described, due to the lack of inflammation in most cases, is an enthesopathy, that is an irritation where a tendon, or fascia, attaches to the bone. Many years ago we thought stretching these was the right treatment, we now know that it is not as it tends to irritate the structures.
  • Massage or roll your plantar fascia! This is an irritation. Rubbing or rolling it will only irritate it more! As we say again and again… “Stop picking the scab! Let your body heal!”
  • Use ultrasound or laser on your plantar fasciitis! Many studies have shown that ultrasound and laser have no greater effect that placebo in the treatment of these conditions. Don’t waste your money or time seeing health professionals who offer this as treatment for you – they are living in the “Earth is Flat” dark ages and have either not kept up with education and evidence or are trying to fleece you!
  • Use ECRB or shock wave therapy! This is an extremely expensive and painful form of treatment that after being disproved by multiple research articles seems to have had a resurgence in Perth again. The evidence of the positive effects of this type of treatment are limited at best. Save your money and get the right, proven treatment!

Do!

  • Manage your load. Use the advice of an expert physiotherapist about whether a period of rest is appropriate, or whether subtle training modification is all that is required. Too many athletes rest these injuries unnecessarily for too long, leading to reduced tissue strength and reduced fitness, compounding the problem.
  • Strengthen your springs! The plantar fascia is an extension of the lower limb “spring”, particularly including the calf muscles and achilles tendon. Commonly, we see weakness in the calf muscles relative to requirements as a major factor in both plantar fascia and achilles tendinitis. A graduated program of strengthening can be commenced almost immediately by an expert physiotherapist, but the wrong program delivered by a health professional who is not highly skilled in this area will cause more pain!

Maybe?

  • Orthotics and taping. These can provide short term relief of pain for some patients, however don’t be fooled into thinking they are a cure or long term solution for your plantar fascia or achilles issues. The key is still sorting out the underlying issues.
  • New/ different shoes. As with the above, there may be short term improvement with a higher heel counter or more cushioning. We will often add a $3 heel wedge to the back of the existing shoe which can provide some pain relief in the early stages of rehabilitation.
  • Calf Massage/ release. Evidence to support this treatment is a bit thin but some clients feel they have reduced pain in the plantar fascia or achille when they have their calf muscles “released”. Certainly worth trying in conjunction with the “dos” as outlined above

The Star Physio team are proud to offer this expert advice and look forward to assisting you with any tendon or fascia problems. Stop wasting money and time, see the experts today!

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