A New Patient with a Plantar Fasciitis Diagnosis
A 57-year-old female arrived at the Sydney Heel pain clinic complaining of pain in the bottom of her heel and the consultation ultimately lead to a plantar fasciitis diagnosis. This lady was a keen golf player and enjoyed 18 holes each weekend. She also enjoyed off-road walking at least twice per week, but had reduced this since the plantar fasciitis diagnosis. This lady described all the classic signs and symptoms of the condition such as pain under the base of the heel which was quite prominent first thing in the morning. She explained to the sports podiatrist that she had been suffering for approximately 12 months and had not found any reliable solution. She informed the podiatrist that there was no real reason for the onset of the plantar fasciitis and that the diagnosis had been made by her GP. She explains to the sports podiatrist that her footwear had not changed and she was using the same hiking shoes and the same golfing shoes thought she had been wearing for several years. She does not recall any particular incident or accident whereby she injured her foot or her ankle. Since the plantar fasciitis diagnosis, this patient had attempted to reduce the symptoms by bathing her feet in warm water with Epsom salts and had been massaging lavender oil into the sole of her foot, to no avail. She also purchased generic arch supports from the chemist in order to reduce the symptoms of the plantar fasciitis but found that these inserts aggravated the arch of her foot and increased the plantar heel pain. She refused to use the generic arch supports any further and began to seek the help of a sports podiatrist.
This lady reports to the sports podiatrist that her GP made the plantar fasciitis diagnosis without the use of x-ray or ultrasound imaging and she was reassured that such procedures were not always necessary. The podiatrist informed the patient that following a physical examination involving mild finger pressure and palpation of key parts of the heel and foot, that the plantar fasciitis diagnosis would be confirmed or denied.
This patient also reported pain in the base of her heel after being seated for long periods of time, such as when leaving the clubhouse following golf. Long periods of standing in the kitchen when cooking also lead to severe discomfort which would lead to the patient needing to take a seat. The application of heat packs temporarily eased the symptoms but were not useful in eliminating the plantar fasciitis.
Plantar Fasciitis Diagnosis by Sports Podiatrist Confirmed
Following a routine physical examination by the sports podiatrist, who palpated key areas of the heel and arch, a definite plantar fasciitis diagnosis was made. The patient was reassured that her symptoms were typical of the condition and that once the treatment plan was executed, she would make a full recovery.
The sports podiatrist carried out a biomechanical assessment and took foot and ankle posture index measurements including arch and heel position when weight bearing and non- weight bearing. An assessment of foot and ankle joint range of motion was conducted as well as muscular function.
The sports podiatrist explained to the patient that now the plantar fasciitis diagnosis had been made she would be presented with one or combination of treatment options that would be selected based on the severity of her condition and the results from the biomechanical assessment.
Plantar Fasciitis Diagnosis – Treatment Plan
The treatment plan following the plantar fasciitis diagnosis was to include the following
- Calf muscles release and stretch.
- Shock wave therapy.
- Prescription orthotics to be used inside walking shoes and golf shoes.
The patient would receive her first shockwave therapy appointment in one week’s time and would receive one every week for approximately four to six weeks.
The prescription orthotics that were designed for this patient were made using a 3D scanner and 3D printer. The design of the orthotics was such that it would not represent a traditional arch support whereby unwanted pressure is applied to the sole of the foot against the plantar fascia. This type of arch support further irritates the condition and prolongs the pain in the base of the heel. Once a plantar fasciitis diagnosis has been made, patients attending the Sydney heel pain clinic are usually fitted with an alternative style of orthotic. This type of insert helps to reverse the inflammatory heal condition within a matter of weeks. The shockwave therapy stimulates healing and accelerates the recovery process.
Please no that the information contained in this case today is related to one particular patient at the Sydney Heel pain clinic and should not be taken as general medical advice. If your doctor or other healthcare practitioner has given you a plantar fasciitis diagnosis then you should seek the help of a sports podiatrist.
Written by Karl Lockett
Sydney Heel Pain Clinic