11/07/2017

Common unsuccessful treatments for Plantar Fascia

Plantar fasciitis is a repetitive strain injury, usually felt as a sharp pain between the mid to inside part of the heel and arch of the foot. It’s at its worse when rising from bed or after a long duration of non-weight bearing, where the first few steps are very painful. Symptoms can resurface after a long duration of standing on hard surfaces and will present with a throbbing dull ache.

The plantar fascia is a thick band of connective tissue that stabilises the foot and keeps the bones and joints in position. Overstretching, repetitive over-use, and bruising will cause microscopic tearing of the fascia, which will then encourage scar tissue to form. Scar tissue is non-elastic, making the fascia even stiffer and more painful.

Contributing factors to this condition are flat feet, being overweight, and poorly fitting shoes with no arch support. Activities that can cause this condition include running, dancing, aerobics, and occupations that require a lot of standing or walking on hard surfaces.

Most health care providers agree that initial treatment for plantar fasciitis should be quite conservative. You’ll probably be advised to avoid any exercise that is making your pain worse. Your doctor may also advise one or more of these treatment options.

Our Plantar Fascia specialist has put together this article as he shares some of his experiences with unsuccessful treatments for this condition.

Stretches

When you stretch your plantar fascia, it can give short-term relief but can prolong the condition. Stretching your calves can also relieve, but this is not recommended, as it is not usually enough to treat it thoroughly. The use of ankle and foot exercises will increase the pull of the fascia on the heel bone, which may cause its aggravation.

Here at Perfect Balance Clinic, one of our Sports Massage Therapists will carefully assess a tolerable level to begin breaking down the scar tissue and encourage the lengthening of the fascia and muscles of the plantar surface. You will be advised to adopt a stretching regimen and possibly different footwear or orthotics

Ice packs / Heat packs

Although you may notice a reduction in inflammation when using an ice pack, it doesn’t actually address the underlying load issue on the Plantar Fascia or the Achilles Tendon. This is why the majority of patients report nothing more than short-term relief. We agree heat packs feel good against the heel, but they actually increase inflammation.

Gel pads / Arch supporters

These can feel good for a short while as they are soft against the painful heel. However, they compress quickly and after a week or 2, they can become less helpful. Some patients report an increase in pain with gel heel cups due to the instability they cause.

Physiotherapy / Massage

When you first discover Plantar Fasciitis and Achilles Tendon pain, seeing a massage therapist and stretching your calf muscles can be helpful. Unfortunately, for those with a more chronic condition, they may not benefit as well to this treatment. A few patients may be unable to perform foot stretches as these will increase the pain in the heel. Our therapists would recommend using the Gait Scan Analysis to get a better understanding.

Doctor

Those suffering from Plantar Fasciitis usually start with a visit to their local doctor who will usually refer for an X-Ray. However, the treatment should be directed at the soft tissue such as the Achilles Tendon or the Plantar Fascia.

Acupuncture

Asymptomatic treatment such as Acupuncture can reduce pain. However, this doesn’t address the underlying need to support the plantar fascia.

Cortisone injections

Injection therapy can help with Plantar Fasciitis. Usually, the pain returns once the cortisone has worn off. Patients who try many different remedies and believing there are no other treatment options available will return to their doctor in search of an answer. By this stage, patients are feeling desperate and will try anything and their GP who will give an injection of cortisone. Here at Perfect Balance Clinic, we would use Shockwave Therapy to help with Plantar Fasciitis.

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