What is plantar fasciitis?
The term plantar fasciitis describes a painful condition affecting the heel. In most people there is no inflammation in the tissues under the heal, therefore it is not a true “-itis” and is now also known as plantar fasciopathy or plantar heel pain syndrome.
This painful condition is very much like a tendinopathy in its near neighbour the Achilles. There is slow and gradual overload within the plantar fascia from which it cannot adapt therefore the fascia becomes degenerative and painful. There are many causes to plantar fasciitis which can be broken down into loading and poor mechanics. Excess loading includes anything that puts too much weight through the plantar fascia, this includes being overweight or increasing activity levels such as taking up long walks or running without adequate pre-conditioning.
What causes plantar fasciitis?
Poor mechanics includes having a tight calf muscle, stiff foot and ankle joints, being flat footed or having general weakness in the foot and ankle muscles. Managing this painful condition of the foot includes losing weight, reducing exercise volume as well as stretching and strengthening of the foot and ankle muscles and perhaps seeing a podiatrist for a biomechanical assessment and receiving advice as to whether you need to wear insoles in your shoes. This is the mainstay of the treatment, and it will still take several months to improve the pain in the heel.
Treatment options for plantar fasciitis
There are two relatively new adjuncts to treatment including shockwave and PRP injections. Shockwave has been shown to be very effective when combined with strengthening exercises for plantar fasciitis. This is a mechanical shockwave, not an electrical shock wave that creates microtrauma within the plantar fascia, stimulating blood flow and cell activity and a healing process in the fascia. We recommend between three and six shockwave sessions to have an effect, and it will still take time for your fascia to improve.
The next relatively new treatment is PRP injections. Research is now showing that doing a course of PRP injections into the irritated area of plantar fascia helps to speed healing and recovery. PRP stands for platelet rich plasma, which is an extract of your own blood full of growth and repair factors that can be injected back into the fascia. If you are suffering from plantar fasciitis and need to discuss treatment options please get in touch. Ultrasound guided steroid injections for plantar fasciitis are also very useful.
Ultrasound guided injections for plantar fasciitis