If you’re trying to diagnose your own limp, well, you’re not alone. Sometimes, finding and arriving at your own answers can feel quite empowering, especially if the problem is causing you discomfort and debilitation.
The ankle joint is said to withstand up to five times your body weight in normal walking and up to thirteen times your body weight when running. With that in mind, it can be quite exhausting to continue with day-to-day life relying on a limp.
The most common cause of heel pain is plantar fasciitis. Other causes of heel pain can include fat pad atrophy, Achilles tendinitis, or tarsal tunnel syndrome.
If you think plantar fasciitis could be the cause of your heel pain, let’s get you more answers about the condition and also look at how physiotherapy can help get rid of the pain and the limp.
What is Plantar Fasciitis?
- Plantar Fascia is a tight fiber that acts as a tension bridge holding together both ends of the foot- from the heel to the toes. It supports the arch of the foot and absorbs shock when standing and walking.
- Plantar fasciitis refers to inflammation or injury to this fascia. Considering the extreme load on this part of your foot, it is easily damaged due to overuse or injury. Some factors that contribute to worsening of symptoms include obesity, above the age of 40 years, and sometimes, high arches or flat feet.
Causes of plantar fasciitis:
- A biomechanical explanation of the condition is the most accepted version. Due to overuse induced microtrauma, there is a wear and tear of the fascia that occurs. This means decreased blood flow which obstructs complete healing of the fascia, resulting in inflammation and pain.
- While it is unreasonable to pinpoint one single factor, a big correlation seems to be the sudden onset of a rigorous exercise routine. It is likely this can be the result of increased load on the foot or even improper shoes.
- Other factors causing plantar fasciitis include biomechanical factors like poor ankle mobility, poor 1st toe extension, repetitive impact, poor arch strength, being overweight, and/or tight calf muscles.
Symptoms of plantar fasciitis:
- The most common symptom is pain first thing in the morning over the first few steps. The pain is felt on both sides of the foot and under.
- In severe cases, sometimes the pain can radiate up the heel. The pain is often described as sharp, which decreases in intensity with movement, rest, and keeping the leg elevated.
- To answer your question, this is where the limp comes about. The pain often returns, as a dull ache. In severe cases, with prolonged sitting or prolonged standing, the pain worsens.
- Other symptoms like stiffness, redness, swollen, and warmth are also seen as part of plantar fasciitis.
Physical Therapy management of Plantar Fasciitis:
- Plantar fasciitis, though it can be quite debilitating, has a 90% chance of complete recovery. With the best physiotherapy services and some orthotic modifications, this is possible.
- A thorough assessment will be your physiotherapist’s first action point. Since biomechanical factors have been established as the cause, you will be assessed within that frame of reference. This looks like an assessment of structures around not just your heel, but also your knee, hip, weight, movement patterns, overall strength etc.
Manual Therapy:
The first goal is pain reduction and decrease in inflammation. Your physiotherapist will use manual therapy, IMS, and/or IASTR to help facilitate tissue release and healing.
- IMS for plantar fasciitis: Intramuscular stimulation for plantar fasciitis would target the muscles around the complex joints of the ankle, sometimes extending all the way up to the calf muscle. A dry needle is used to cause microtrauma inside tight muscles to release and repair. Releasing tight muscles will help relieve tension in the plantar fascia.
- IASTR for plantar fasciitis: Instrument Assisted Soft Tissue Release is an effective strategy for releasing tightness. It is a procedure in which an ergonomically designed instrument is used to stretch the adhesions or scar tissue.
Stretching and strengthening exercises for the foot:
Any additional movement or release obtained after IMS or IASTR must be maintained, that is where stretches and exercises come into play. Some of the common stretches that your physiotherapist will include in your program are as follows-
- Deep Ankle Plantar Fascia Stretch:
Posture: sitting on a chair
Instructions: Put your foot towards a wall and have your toes fully extended back. Lean forward into the wall so you can feel the stretch in the plantar aspect (sole)of your foot.
Prescription: Do 3 reps, 30 second holds, at least 3xday.
- Plantar Fascia Ice Water Bottle:
Posture: sitting on a chair
Instructions: Put your foot onto frozen water bottle and roll your foot up and down. Make sure to incorporate every part of the foot.
Prescription: 30 seconds each, at least 3xday.
Shockwave Therapy for Plantar Fasciitis:
- In chronic and stubborn cases of Plantar fasciitis, your physiotherapist might recommend shockwave therapy. It has been shown to be effective and thorough.
- In this treatment, shockwaves/soundwaves are delivered at a pre-set frequency to the inflamed area. You will feel this as a mild thumping on the sole of your feet.
- The purpose of shockwave is to channel the body’s natural healing process to the point of application.
Plantar fasciitis symptoms respond well to physiotherapy treatment and often subside within 6 weeks. In addition to conservative physiotherapy treatment, your doctor may recommend some orthotic modifications to ensure pain-free and supported walking.
At Revere, we have a team of expert physiotherapists who are skilled in hands on manual therapy methods and a state-of-the-art shockwave machine.
If you have any questions about your symptoms or physiotherapy treatment, feel free to reach out to us at info@reverephysio.com. We are offering a free 10 minute consultation call with our expert physiotherapists. Call us at (604) 566-5108
If you feel ready, book an appointment with our expert physiotherapists. Share this article with friends or colleagues who also struggle with heel pain and could benefit from the best physiotherapy services at Revere Physiotherapy.
