Lynx100
-
Total Posts
:
965
-
Reward points
:
10
- Joined: 2/24/2005
-
Status: offline
|
Heel Pain (Plantar Fasciitis)
-
Friday, May 20, 2005 11:27 PM
( #1 )
What’s Plantar fasciitis Plantar fasciitis is a condition cuased by inflammation of the bit of connective tissue (called the plantar fascia) going from your heel to where your toes start on the underside of your foot. As with most/if not all cases of inflammation, this causes pain. This condition sometimes is called referred to as heel spurs however many people how have no symptoms at all bone spurs on their heel and many patients with plantar fasciitis have no bony heel spur. While Plantar fasciitis isn’t the only cause of heel pain, it is the cause in the majority of the cases. During running or walking, the vertical forces in the foot at foot strike may reach 2-3 times body weight. This is where the plantar fascia and the arch of the foot come into play as the foot's shock absorption mechanism. During the heel-off-the ground part of walking or running, tension increases on the plantar fascia, which acts as a storage of potential energy. During toe-off-the-ground phase, the plantar fascia passively contracts, converting the potential energy into kinetic energy and imparting greater foot acceleration. So how do you know if you have Plantar fasciitis? Patients complain of pain underneath the heel that is worst first thing in the morning when waking up or after a period of nonweightbearing activity. The pain often is described as a searing or tearing of the tissues under the heel and often improves with further activity, only to recur following continued or prolonged weightbearing activity. The pain may also be a dull ache at the end of a long day of walking or standing. Diagnosis of plantar fasciitis is confirmed by the doctor if there is pain near the origin of the plantar fascia (around the heel) that often is aggravated by stretching the fascia. The pain be brought on when you dorsiflex the ankle (as if you were juggling a soccer ball). Occasionally, pain radiates toward the toes when a tender area is squeezed. What causes Plantar fasciitis? Training errors - If there has been an increase in distance, intensity, or duration of activity.
The addition of speed workouts, plyometrics, and hill workouts are particularly high-risk behaviors for development of plantar fasciitis.
Running indoors on poorly cushioned surfaces is also a risk factor.
Poor shoes
- Athletic shoes rapidly lose cushioning properties
- Lightweight and minimally cushioned shoes (instead of heavier training flats) are also at higher risk of developing plantar fasciitis.
- Athletes should be wearing an appropriate shoe type for their foot type and
Genetics
- Overpronation, pes cavus, differences in leg-length
- People with low-arched or high-arched feet have increased stress placed on the plantar fascia with foot strike (Reid, 1992).
Other
- Tightness in the calves and soleus muscles and the Achilles tendon
- Age older than 40 yrs
- Obesity
- Repetitive stress activities, and age older than 40 years..
- the presence of a heel spur (osteophyte) although at the moment there a bit of disagreement regarding the role of heel spurs and plantar fasciitis.
What can YOU do about it?
When you first feel the heel pain - Ice & rest
- Ice is the first-line anti-inflammatory treatment for plantar fasciitis. This treatment can be applied by ice massage, ice bath, or ice pack.Ice packs usually are placed for 15-20 minutes.
- Icing should be performed after completing exercise, stretching, and strengthening.
- Resting and correcting training errors are critical to the treatment.
- You must modify activities that aggravate the condition; it may be as simple as decreasing the amount, frequency, or intensity of activity.
- Make an appointment with the doctor (if possible, a sports doctor)
What can the DOCTOR do about it?
- Usually, no special procedures (such as X-ray etc) are needed.
- The doctor will advise you about activity restriction, passive stretching, ice and heat, visco-elastic heel cushions, and oral anti-inflammatory medication.
- You will be prescribed nonsteroidal anti-inflammatory medication to relieve pain,
- You will possible be referred to a podiatrist for arch taping, support, orthotics.
For cases that dont respond to this, a minor surgery might be needed to release the plantar fascia. A surgical release has a 70-90% success rate in treating patients with plantar fasciitis
Corticosteroids: In cases of re-occuring plantar fasciitis, corticosteroid injection may be considered. If this is the case, a plain X-ray may be taken before injecting.
Night splints: Most people naturally sleep with their feet in a plantar-flexed position, which causes the plantar fascia to be shortened. Night splints are designed to keep the ankle in a neutral position during sleep, essentially passively stretching the calf and the plantar fascia for a prolonged period. So in theory theory, the night splint allows the plantar fascia to heal in the elongated position, which in turn decreases the tension with the first step in the morning.
Rehabilitation after long-term shin splint injury
The initial physical therapy program for plantar fasciitis is based around stretching of the calf and foot in combination with a strengthening program. The stretching program should include wall stretches with the knee both in the extended and flexed positions. Here are a few exercises that are used by physiotherapists/physical therapists to help in the rehab of the injury.
Towel stretch: Sit on a hard surface with your injured leg stretched out in front of you. Loop a towel around the ball of your foot and pull the towel toward your body keeping your knee straight. Hold this position for 15 to 30 seconds then relax. Repeat 3 times. When the towel stretch becomes to easy, you may begin doing the standing calf stretch.
Standing calf stretch: Facing a wall, put your hands against the wall at about eye level. Keep the injured leg back, the uninjured leg forward, and the heel of your injured leg on the floor. Turn your injured foot slightly inward (as if you were pigeon-toed) as you slowly lean into the wall until you feel a stretch in the back of your calf. Hold for 15 to 30 seconds. Repeat 3 times. Do this exercise several times each day. When you can stand comfortably on your injured foot, you can begin stretching the bottom of your foot using the plantar fascia stretch.
Plantar fascia stretch: Stand with the ball of your injured foot on a stair. Reach for the bottom step with your heel until you feel a stretch in the arch of your foot. Hold this position for 15 to 30 seconds and then relax. Repeat 3 times. After you have stretched the bottom muscles of your foot, you can begin strengthening the top muscles of your foot.
Frozen can roll: Roll your bare injured foot back and forth from your heel to your mid-arch over a frozen juice can. Repeat for 3 to 5 minutes. This exercise is particularly helpful if done first thing in the morning.
Towel pickup: With your heel on the ground, pick up a towel with your toes. Release. Repeat 10 to 20 times. When this gets easy, add more resistance by placing a book or small weight on the towel.
Next, you can begin strengthening the muscles of your foot and lower leg by using elastic tubing.
Resisted dorsiflexion: Sit with your injured leg out straight and your foot facing a doorway. Tie a loop in one end of the tubing. Put your foot through the loop so that the tubing goes around the arch of your foot. Tie a knot in the other end of the tubing and shut the knot in the door. Move backward until there is tension in the tubing. Keeping your knee straight, pull your foot toward your body, stretching the tubing. Slowly return to the starting position. Do 3 sets of 10.
Resisted plantar flexion: Sit with your leg outstretched and loop the middle section of the tubing around the ball of your foot. Hold the ends of the tubing in both hands. Gently press the ball of your foot down and point your toes, stretching the tubing. Return to the starting position. Do 3 sets of 10.
Resisted inversion: Sit with your legs out straight and cross your uninjured leg over your injured ankle. Wrap the tubing around the ball of your injured foot and then loop it around your uninjured foot so that the tubing is anchored there at one end. Hold the other end of the tubing in your hand. Turn your injured foot inward and upward. This will stretch the tubing. Return to the starting position. Do 3 sets of 10.
Resisted eversion: Sit with both legs stretched out in front of you, with your feet about a shoulder's width apart. Tie a loop in one end of the tubing. Put your injured foot through the loop so that the tubing goes around the arch of that foot and wraps around the outside of the uninjured foot. Hold onto the other end of the tubing with your hand to provide tension. Turn your injured foot up and out. Make sure you keep your uninjured foot still so that it will allow the tubing to stretch as you move your injured foot. Return to the starting position. Do 3 sets of 10.
<message edited by Lynx100 on Friday, May 20, 2005 11:30 PM>
|