Plantar Fasciitis - Like walking on glass every morning when you get up!

Plantar Fasciitis - Like walking on glass every morning when you get up!

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Plantar fasciitis, also known as plantar fasciopathy or plantar heel pain, is a common condition that causes pain in the heels and pads of your feet. This is usually from irritation to the plantar fascia, which is a thick ligament like structure that covers the underside of our feet, but it can also be from irritation to the bones (heel spurs), foot muscles, or even the nerves in the feet. As all of these conditions are often linked and the treatments are similar, the experts have moved to calling this condition plantar heel pain.

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Do I have plantar fasciitis?

Plantar fasciitis and plantar heel pain almost always present with pain on the underside of your foot around the heel. If you also notice pain when you first get out of the bed in the morning, or after sitting for a long time, chances are you've got it. Many people describe this feeling like walking on glass every time they get up in the morning. If you can also push on your heel and feel a really sore area just where the plantar fascia meets the bone, then that makes it even more likely!

Generally, there is little need for any scans of the foot, but x-rays, ultrasounds, CT scans, and MRI scans can let us know if there are any bone spurs, stress fractures of the calcaneus (heel bone), or even tears through the plantar fascia. When you've had this condition for a long time, and have tried many things unsuccessfully, then a scan is a good idea to help get down to the bottom of it. If it is your first time experiencing foot pain though, it's often best to try some treatment first as they have a high chance of working for first timers.

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What caused my plantar fasciitis?

There are many causes of plantar fasciitis and plantar heel pain, and most of them relate to doing things that irritate the soft tissue structures (bones, ligaments, muscles, tendons, and fascia) in the feet.

Our Physiotherapists and Chiropractors at Milsons Point Health commonly see these patterns in people with plantar fasciitis:

• Increasing in weight: where being heavier starts to strain the feet more.
• A sudden change in activity: such going overseas and walking a lot, or starting up a new walking/running program all of a sudden.
• Walking around barefooted a lot of hard floors.
• Wearing poorly supported shoes: such as elastic, floppy shoes (we do not like Sketchers!), or shoes that are too big or too old.
• Having flat feet (pes planus), where the arches of your feet are low and offer less support.
• Having poor running mechanics: where heel strikers more commonly report heel pain.

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Treating plantar fasciitis

When it comes to treating plantar fasciitis and plantar heel pain, there are many reported things that can help like taping, orthotics, heel cups, acupuncture, dry needling, shockwave therapy, massage, rolling the feet on an iced bottle of water, stretching, strengthening exercises, laser therapy, wearing better shoes, night splints, and even special socks.

The list really does just go on and on but finding out which treatment mix is right for each person is the hardest part. At Milsons Point Health, we start with the 5 recommended treatments for people with plantar heel pain, which have been recommended by experts in a recent study from 2021:

• Education: on supportive shoes, gradually increasing activity levels if just starting to after a long break, or reducing activity levels if there are signs of overdoing it.
• Stretches: targeted at the feet, calf muscles, and hamstring muscles, especially in the morning before you get out of bed to reduce the walking on glass feeling.
• Taping: which supports the foot arches. Relief of pain can indicate that orthotics can be useful as a longer term solution.
• Shockwave therapy: which has been shown to be useful for persistent cases of plantar fasciitis.
• Custom Orthotics: such as heat-mouldable orthotics that our Physiotherapists and Chiropractors can create for you, or working with our network of local Podiatrists who can help create more advanced and technical orthotics for stubborn and complex cases.

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Other things we look at are how you are using the foot currently, and might recommend doing include:

• Activity modification: such as wearing slippers inside with a more supportive arch (if you like being barefoot a lot).
• Exercise modifications: such as halving your current distances of walking or running, and slowly adding back on +10% each week. We might also recommend a  break from weight bearing exercises to let the foot settle, and temporarily switching to swimming, cycling, or rowing instead.
• Strengthening other areas of the body: such as the small foot muscles, calf and shin muscles, hamstrings, or gluteal muscles. These all make up the posterior chain of your body, which all work as a team when you use your leg.
• High load strength exercises: where calf raises with the toe extended has been shown to help people with persistent plantar fasciitis. We personally see this as one of the best ways to stop the condition from coming back (the stronger you are, the more you can do with your foot without irritating it!).

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The most important thing to remember with plantar heel pain is that there is no one size fits all solution for it and it can linger in some cases for up to 12 months. When applying the right treatments though, the pain, discomfort, and limitations on your life can be very minimal, and many of our patients around the Milsons Point, Kirribilli, and North Sydney areas experience low levels of discomfort whilst recovering from this condition.

So if you think you might have plantar fasciitis or plantar heel pain, make an appointment with one of our Physiotherapists, Chiropractors, or Exercise Physiologists at Milsons Point Health by calling us on 02 9190 7654 or booking in online today!

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