Plantar Fasciitis

Plantar Fasciitis

By Amir Saipoor, BSc in Podiatric Medicine, PGDip Podiatric Surgery

Please get in Contact to book an appointment with Mr. Amir Saipoor

Abstract

Specialist Podiatrist, Mr. Amir Saipoor, provides a fascinating and lucid overview of the causes, current diagnostic methods and common treatments for Plantar Fasciitis.

Article

Plantar Fasciitis is one of the most common causes of heel pain (McPoil et al, 2008). It involves inflammation of a thick fibrous band, that runs across the bottom of your foot connecting your heel bone to your toes. Plantar fasciitis commonly causes stabbing pain, especially with the first steps in the morning, and as a patient walks more the pain reduces to some extent.

The origin of the plantar fascia is located at the heel and inserts into the base of the toes. It is a thick fibrous sheet that divides into 5 sections distally and extends to the phalanxes, overlapping the flexor tendons. It forms part of the stabilizing structures for the arch, aids in shock absorption and is an important factor in gait and dynamic activity (Hicks, 1954).

The exact cause of plantar fasciitis is poorly understood. However, it is considered that plantar fasciitis is a result of faulty biomechanics, attributed to excessive (over) pronation (Kwong et al, 1988). This suggests that increased amounts of stress to the plantar fascia results in stretching and overloading (Bolgla and Malone, 2004). Over a period, the repetitive stress can cause micro-trauma and micro-tears in the fascia, resulting in an inflammatory response and pain (Puttaswamiah and Chandran, 2007). Other factors described in the literature are Obesity / Overweight, Change in Activity, Pregnancy, Flat feet, High Arches, Inflammatory Arthritis & wearing shoes with poor support (McPoil et al, 2008).

Diagnosis of plantar fasciitis is usually deduced through patient history, however sometimes the specialist in care may request an X-ray, ultrasound or MRI to investigate further. Other diagnoses such as Heel bone bruising (Contusion), Baxter’s nerve entrapment, or calcaneal bursitis may need to be excluded.
Several treatments are available for plantar fasciitis, however the immediate standard treatment as for any soft tissue injury is R.I.C.E, which stands for:

– R: rest
– I: Ice
– C: Compression
– E: Elevation

This aims to allow rest from pain-provoking activity, as well as reduce pain and/or any swelling by applying ice 2-3 times daily for 5-10 minutes. In addition to this, patients can take anti-inflammatory medication (if tolerated). Changing footwear to more supportive trainers or shoes should be considered, as flat shoes may allow more abnormal movement than a supportive shoe. In some instances insoles may be required to support the foot and reduce the stress upon the plantar fascia. Other treatment options include steroid injections to reduce the inflammation locally and shockwave therapy. However, both are utilized if noninvasive treatments fail.


Appointments & Enquiries

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

Our Partners

c-logo

The London Musculoskeletal Centre

Testimonials

Back on the dance floor

Mr Kaser Nazir was my second opinion foot specialist after not being happy with the "verdict on my future before". I had a plantar plate injury. For a full time professional dancer teacher this was devastating. After meeting Mr Nazir I felt instantly reassured and I knew this is all going to be good. He Continue Reading

Monika Molnar

<< Prev
Next >>

Recent Posts: London Musculoskeletal Centre | Orthopedic & Sports Medicine

Treating Foot Injuries

Treating Foot Injuries

The treatment for your foot injury would depend on the type and cause of your injury. For some treatment is straightforward and simple. Shoe inserts are a great option in these cases as they provide you a lot of relief from the pain that may happen because of foot injuries. You can get them on

Pain after A Hip Replacement

Pain after A Hip Replacement

When it comes to pain management after a hip replacement surgery, the first question that comes to your mind is how much post operative pain is normal. During this surgery, the surgeon would remove with the damaged parts of your hip joint.