Pain and Performance Clinic

Plantar Fasciopathy

Suffering from morning heel pain?

This can be a very sore, very frustrating condition usually effecting men in their 40s/50. No one treatment works really with this but a lot of little things need to be done. Pelvic control, core strengthening, loosening out calves and hamstrings, using a heel pad, correct foot-ware and losing some weight are all part of recovery.

Heel Pain

What is it?

A mechanical over- load problem caused by poor movement mechanics.(Not Inflammatory condition)
  • Example 1- Anterior Pelvic Tilt = increased load on calf, increased calf muscle tone and reduced ankle dorsiflexion. This can lead to excessive foot pronation.
  • Example 2- Over striding. Forces aren’t well distributed and increased eccentric load on Tibialis Posterior , Gastroc and Soleus. These combined with increased activity produces pain in the Plantar Fascia.
These combined with increased activity produces pain in the Plantar Fascia.

Symptoms:

  • Pain after rest- morning pain, prolonged sitting
  • Can be pain on prolonged standing/walking
  • ‘Bruised’ type pain
  • Eases out after a few steps/minutes

Testing:

  • Range of motion testing- especially ankle dorsiflexion
  • Accurate palpation
  • Standing posture
  • Walking assessment-pelvic lateral movement and rotation
    • heel strike
    • toe off. Where is this happening – callus formation?

 

  • Single leg stance
  • Neural Testing (Medial Calcaneal Nerve, Lateral Plantar Nerve)
  • MRI or Ultrasound if you query a tear (X- Ray no use)

Exercises

Correct Walking technique

If over-striding , shorten the stride- landing on the front part of the heel with a slight knee bend. Best to use a simple cue – ‘walk quietly’, ‘lift knees slightly higher’, ‘land softly’.

 Home Exercise Programme

(Indicated If pain eases within 20 minutes in morning) 15 minutes daily x 6 weeks.
  • Calf Stretch 20 seconds x 3 reps
  • Plantar Fascia stretch 1 minute x 2 reps
  • Strengthening- ‘Don’t fall over’ exercise x 30 reps
(Repeat the above 3 times. )

Constant taping

Watch out for: Pain at night or if pain gets worse during the day they may have a bone or periosteal response. (Pain limited to less than 30 minutes)

IT’S TIME
TO TAKE
CONTROL

Questions, bookings or feedback? Contact me by any of the channels below. I’ll respond ASAP!

P: 087 652 9287

E: tommy@painandperformanceclinic.ie

A: Pain & Performance Clinic, 12 Trinity Court, Fonthill Business Park, Dublin 22

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