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Plantar Fasciitis (Fasciopathy) heel pain?

Image source: http://bodyinmotionchiropractic.com

You may be experiencing plantar fasciitis, which we now correctly refer to as plantar fasciopathy.

good-heel-picture
Image source: www.arlingtonpodiatrycenter.com

This heel pain is widely known as plantar fasciitis (‘itis’ – inflammation) as previously health professionals thought that the pain was caused by significant inflammation of the tendon at its’ attachment to the bone.

Latest research has proven that although there may be an initial inflammatory component the main problem is due to changes within the makeup of the Achilles tendon and plantar fascia complex.

Image source: https://www.healthdirect.gov.au/plantar-fasciitis

A change within the structure of the Achilles tendon and plantar fascia complex is the source of pain in plantar fasciitis (fasciopathy).

Fascia and Tendons transfer forces from the muscles to the bone to allow us to move.  So when you run or jump, the plantar fascia transmits the forces of the calf muscles to allow push off while stabilising the ankle joint (9 x body weight when running).  Sometimes in life there is a change in activity or ‘load’ on the lower limbs which affects the load through the tendons eliciting a significant change.

There can be a spike in training (such as ramping up running for a marathon in 2 months time) or a relative unload through sickness, extended holiday or even a change to low load activity such as swimming from running.  Sometimes the change might be due to different footwear (from boots in winter to thongs in summer) or a change of job that requires prolonged standing all day.

Whatever the reason for the change in load the pain will come on 4-6 weeks later.

training-error-graph

What we know:

To treat Plantar Fasciitis (Fasciopathy) physiotherapy will:

This fascia & tendon specific treatment regime takes 3-6 months to return to your level of exercise depending on levels of pain and how long you have been suffering.
calf-raises
image source: https://www.popsugar.com.au

Pain relieving exercise is the 1st stage of treatment, holding the position of a heel raise.

Once pain has settled, move onto weights, fascia and tendon need heavy weights to stimulate the tissue to adapt and get stronger.

soleus-ex
image source: https://www.sportsinjuryclinic.net/
hop
image source: http://coachrozy.com/wp-content/uploads/2017/10/hop.jpg

Then progression to plyometric (bounce) exercises.

Gradually load, guided by pain, to return to your exercise.  It can take 3-6 months to get to this point, but by specific exercise you will strengthen your plantar fascia.

If you have been walking on glass first thing in the morning and your heel pain is now affecting your ability to exercise, you probably have plantar fasciitis, which is now correctly termed plantar fasciopathy.  Physiotherapy directed specific fascia and tendon exercises will allow you to get back to your favourite activities.  Doing nothing will change nothing.  You need to reload gradually and get back to ‘Moving to Better Health’ with Active Solutions Physiotherapy.

image source: https://irishnomadontherun.com/

Click on the links below to book online for a physiotherapy assessment and treatment or give us a call on 0438 648 884.

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