Treatment of Plantar Fasciitis

surgery plantar fasciitis

 

There are many different ways of dealing with heel pain but the following list describes some of the primary treatments that have proved most effective:

Rest: Stopping all activity immediately is the first step to taking proper rest; resisting the urge to return to your former level of activity before the pain has heeled is the second step to taking proper rest. Insisting that a person experiencing heel pain rest more often is a precarious situation, because reducing pressure on the foot is necessary but reducing activity levels can also lead to muscle atrophy which in some cases is part of the problem to begin with.

It takes 12 to 36 hours for most injuries involving the soft tissues of the body to reach a peak level of soreness, making it difficult to pinpoint which activity (such as doing squats or climbing up stairs) caused the pain in first place, and which activity will then aggravate the condition. Swimming is one of the few alternative workouts that pose little threat of causing re-injury.

Ice: Icing down soft-tissue injuries is just as effective for weekend warriors suffering from heel pain as it is for professional athletes with chronic elbow or knee injuries. Ice remains one the top treatments and is used by doctors and athletic trainers worldwide to treat inflammation issues.

Applying ice after immediately after aggravation or injury is essential, if you do not have an ice-pack or adequate substitute then make sure you get to your freezer as soon as possible. One of the best tips I’ve ever received is to remove the label from a can of vegetables and pop it in the freezer; it’s reusable and it won’t melt and drip, and  metal transfers cold better than a plastic. Please remember to wrap the tin in a towel or t-shirt before applying to the skin. If you choose to ice the skin directly make sure you only do so for a maximum of 5 minutes at a time; even 10 minutes is too long for this kind of contact.

The fastest way to heal an inflammation of this type is to keep it as cool as possible for the first 48 hours after injury; icing it down for 5 minutes reduces the benefit of constant coolness by 50%, but it’s still better than nothing. It’s best to apply ice in the after the day’s activities are more or less at an end.

While icing an injury is one of the best ways of preventing scar tissue from forming in the muscle or tendon tissue and one of the best ways to prevent and reduce inflammation it’s important to remember that care must be taken with your skin; you don’t want to damage surface tissues for the sake of reducing muscle swelling. Stick to a maximum of 5 minutes of icing at a time, but if you experience extreme discomfort or you notice severe discoloration of the skin then alternate 1 minute of icing with 40 seconds of not applying ice.

Stretching:  Tight and/or or inflexible calf muscles is one of the major causes of heel pain. Aside from putting more strain on the foot muscles in general, tight caves can cause the foot to pronate inwards and when this happens a painful case of plantar fascia—and the resulting heel pain, is not usually very far behind. Start by warming up the calf muscles with a few shallow heel dips on a low stair before going deeper into the stretch; if you pull too hard on a cold muscle it can cause an injury or aggravate an issue that is already present. Many people who suffer from constant heel pain have found relief in an increased flexibility in the calf muscles.

Tape: Properly applied athletic tape can support the planter fascia and reduce the tension load it bears. There are many qualified physiotherapists who have great experience and success in alleviating heel pain through this kind of treatment.

Arch Support: Having proper arch support is one of the top recommendations of doctors and podiatrists, and it many, many sufferers of heel pain have found relief by using orthotic devices.

Lose Weight:  One recommendation that is the most difficult to implement when dealing with heal pain is being told to lose weight; but it’s also one of the most important steps you can take if you are overweight and having problems with foot pain. If you are experiencing heel pain and you know you need to lose a couple of pounds then talk to your doctor and/or find a support group in your area, because no matter what else you do if you’re overweight then your heel pain will likely return time and again.

Upgrade Your Footwear: Another common culprit in foot pain is wearing shoes that do not provide sufficient arch support, adequate cushioning, a raised heel, and proper flexibility at the front of the shoe (not the middle of the shoe) so that your toes can bend back easily. Stiff shoes demand more flexibility from the calf muscles because they increase the effective length of your foot. When this occurs your foot must bend further back further when walking in order to compensate for the loss of motion, but your foot cannot actually bend far enough back to compensate and it just ends up causing increased tension in the Achilles tendon and plantar fascia.

Heel Pads: The primary relief that heel pads provide is to raise the back of the foot which then relieves tension in the calf muscles, particularly if they are tight. A secondary benefit is that pads can also cushion heel and created a barrier between the skin and the impact caused from walking or running.

Tips for Runners and Walkers: If you are running or walking you will have to take special care not to re-injure yourself. Make sure you warm up before heading out, avoid all hills, take shorter strides, and make sure you wear the best shoes possible. It is absolutely crucial that you stretch afterwards, and it wouldn’t hurt to ice down your feet either.

Gym Rats: You will unequivocally need to take a break from performing squats, doing step classes, or using benches to perform step-ups.

Anti-inflammatory Medication: Aspirin or Ibuprofen may provide relief from inflammation but don’t bother with Tylenol; it simply won’t help to reduce discomfort caused by inflammation.

Topical Creams: Some people find that these types of gels and creams work wonders so if you can find a topical anti-inflammatory treatment you might find it effective. Otherwise, elevation and compression are very effective at reducing inflammation.

Heel Pain in the Morning: If you suffer from increased discomfort first thing in the morning then you are likely suffering from plantar fasciitis, and aside from treating that issue you will have to take special steps to warm up your calf muscles upon waking. Wearing a special splint to bed can help keep the muscles stretched but it may not help enough to justify the awkwardness of sleeping while wearing it. You should also be sure to wear shoes with adequate arch support and a raised heel immediately upon waking; going barefoot is not recommended.

Summary

You may be tempted to ‘walk off’ your heel pain but this will not help very much in most cases, and will in fact likely make your condition worse. It’s best to apply as many of the treatments as possible and as routinely as possible while you slow down your activities and give your feet plenty of time to heal. It may be necessary to use treatments continuously; heel pain can be chronic and cyclical, especially if you have a job that requires excessive standing, so it’s best to take precautions even when heel pain isn’t present.

People suffering from foot and heel pain often find it difficult to get their doctor to take their pain seriously; if you have had, or are having this kind of experience with your own GP it may be in your best interest to work with a podiatrist as this is their field of expertise.

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