Best Treatment for Plantar Fasciitis.
What is it?
Plantar Fasciitis, heel pain or heel spurs is broadly described as pain near the heel of the foot. It is usually as an overuse injury, although the experts at Star Physio describe it as an “under-prepared injury” where someone has taken on exercise beyond their capacity. This leads to an initial period of inflammation, but usually found to be degeneration of the plantar fascia. This requires careful rehabilitation by a physiotherapist who understands the evidence on treatment, for a successful long term outcome. Previous treatments of rolling, stretching and massage have been shown to do very little at best, and often make things worse, so read ahead to learn more!
Why is there so much around at the moment?
COVID-19 has caused many challenges, including a change in exercise patterns. With gyms being closed, group training and classes paused and even cycling groups being shut down until recently, we have seen a significant increase in people running as an alternative to their usual exercise. This increase, or for many change in activity with more impact or “spring” required is the main reason we are seeing so much plantar fascia pain currently.
On top of this, the loss of strength through closed gyms and strength decay (Check out Steve Jeffries’ great blog on that here) has provided a double “whammy” of less strength and more requirement!
Plantar Fasciitis is commonly seen in runners or triathletes who increase their training too quickly. It is also common in females around the period of menopause due to hormonal changes. At the moment, we are seeing record numbers of patients with this heel pain due to a change in activity around the Corona Virus and the advice and treatment many are given is of some concern.
Is it easy to treat?
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are many health professionals, including well known physiotherapists, who are advertising and providing disproven and outdated forms of treatment for this common problem.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 below to help you choose the right physiotherapist. What often starts as a nuisance niggle in the heel in the morning, or at the start of a run, can quickly turn into an issue which can affect your exercise and enjoyment of life for many months. Don’t delay, get in and let one of our experts give you the right information and advice to get you back on track quickly!
At Star Physio, we 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 https://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. https://starphysiowa.com.au/contact-us/
What about scans?
Sometimes scans or x-rays will show microtearing, or a bony spur in the area of pain. These are often not be related to the pain. In most cases, there is no need to get X-Rays or other scans, as the results are unlikely to change the way the a good physiotherapist will manage your injury.
- 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!
- 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!
- Get an expert running analysis and advice on footwear… not from a shop with vested interest!
- 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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