One of the more common foot complaints is pain underneath the foot, either in the middle of the arch itself, or where the arch meets the heel bone.
The primary piece of tissue that runs through the undersurface of the foot is called the plantar fascia. Inflammation of this structure is called plantar fasciitis - and if it persists for long enough, a little heel spur (bony growth off the heel bone) may form.
What causes plantar fasciitis?
Plantar fasciitis usually develops gradually, although once present sufferers can experience very sharp stabbing pain – particularly first thing on the morning, or when they move again after being seated for a period of time. There are a range of potential causes, including flat feet, tight calves, poor footwear, or excessive training loads. If the cause is not correctly identified, treatment only provides short term relief. Hence, a thorough biomechanical examination of sufferer’s feet should be undertaken.
How is plantar fasciitis diagnosed?
Scans (X-ray, MRI) are not usually required. The key to correct diagnosis lies in a thorough biomechanical assessment. Here at Back In Motion Camberwell we utilise Gaitscan™ technology to do this. The Gaitscan™ pressure plate (by far the most sensitive of its kind with over 4000 sensors scanning at 300Hz) is able to capture force distribution through your foot as you walk, in great detail. The results are then converted into 2D & 3D images. Your physiotherapist can use this information to determine any need for orthotic support (whether that be custom made, or prefabricated orthotics). The Gaitscan™ process takes about 20 minutes, and is a FREE service to Back In Motion Camberwell clients.
How to fix plantar fasciitis?
Depending on the exact biomechnical factors present in your case of plantar fasciitis, treatment could require any of the following:
- Calf & plantar fascia stretching
- Self massage of the plantar fascia
- Ice/Anti-inflammatory medication
- Calf strengthening
- Orthotic support for your footwear
- Footwear modification
- A cortisone injection
- Surgery to debride (remove scar tissue from) the plantar fascia
Even if there is a heel spur visible on an x-ray, simply cutting it out will not fix the issue with the arch itself, and so generally doesn’t resolve people’s pain. You really do require a through physiotherapy assessment to have the right treatment plan put in place. Should you have a severe enough case to warrant a review with an orthopaedic surgeon, we do have 2 lower limb specialist surgeons who consult from our rooms on a regular basis.
Adrian Quinn (B.Physio) - Practice Director @ Back In Motion Camberwell