Movement is Medicine: Heel Pain – the Dreaded Plantar Fasciitis
If you have ever had plantar fasciitis it is not something you will quickly forget. Plantar fasciitis can be very painful and debilitating. The pain typically is there the moment your foot hits the ground in the morning. Most patients will describe that they have to hobble for the first several steps. Then the symptoms may get a little better, however once you sit down and go to get up again, the sharp pain and hobbling returns.
Plantar fasciitis (PF) is a common musculoskeletal injury that affects approximately 10 percent of the population (Goff 1999) and accounts for 15 percent of all adult foot pain (Rome 1997). It was initially thought that PF was an inflammation of the plantar fascia however research has shown that it is a non-inflammatory condition.
Risk factors for developing PF:
- Age
- Decreased ankle dorsiflexion
- Decreased first metatarsophalangeal joint extension
- Prolonged standing
- Increased body weight
While none of us can control the first factor related to PF, we can control the remaining factors. A recent study in the Journal of Orthopedics and Sports Physical Therapy determined that only 7.1 percent of patients with plantar fasciitis are referred to physical therapy (Fraser 2017). This is unfortunate as patients sent to physical therapy received evidenced based manual therapy and supervised exercises and they averaged fewer visits and a lower cost of care.
Here are 5 suggestions on what you can do if you are experiencing heel pain.
- See your doctor and request physical therapy or go directly to your physical therapist: Research has shown that the earlier the intervention the better.
- Don’t go barefoot or wear flip-flops to minimize strain on the plantar fascia
- Immediately begin a stretching program specific for the plantar fascia (see stretch below)
- Try a padded non rigid orthotic device to assist with shock dissipation
- Consider changing shoes: Wear shoes that have good heel cushioning with a 10mm heel to toe drop. The midsection of the shoe should be firm and well cushioned. The toe section should also be firm and resist excess bending.
The key to recovering from plantar fasciitis is early intervention and evidenced based treatment options. If you are experiencing heel pain give your physical therapist a call and let us help you get back to walking pain free.
Dr. Maria Fermoile is a Doctor of Physical Therapy at Alliance Health in Fresno. She will be happy to answer questions submitted to maria@alliancehealthfresno.com. Learn more about movement, fitness and health in this space each week or by visiting www.alliancehealthfresno.com, or calling 478-5833.
