Case Study: Shockwave Therapy for Plantar Fasciitis in 47 Year-Old Male Runner

Presentation: plantar fasciitis

A 47 year old male presented to the Sydney Heel Pain Clinic requesting plantar fasciitis treatment. He reported heel pain in both feet for at least 7 or 8 months. He was otherwise fit and healthy. The patient told the sports podiatrist that he had increased his running distance lately and he had added 2 extra training days in preparation for his workplace charity fun run. He was running 6km five days per week when the plantar fasciitis kicked in.

Pain symptoms were consistent with plantar fasciitis

When asked to describe his pain from the plantar fasciitis, the patient said it was very sharp and deep in the centre of the base of his heel. He said that his heel pain was always very bad first thing in the morning when he got out of bed but usually subsided after a few minutes of walking- a classic sign of of plantar fasciitis. The patient told the sports podiatrist that he was able to run with bearable pain after around 5-10 minutes of starting. The patient was particularly concerned that once he had finished running, his heel pain would become severe.

The patient had tried some home remedies for plantar fasciitis

The patient informed the sports podiatrist that one of his colleagues had mentioned he may have plantar fasciitis, and based on that, he had done some reading on the internet which led him to try some home remedies to relieve his heel pain. He had been using ice packs to ice his feet following his training. He had also purchased some over-the-counter orthotic inserts that the pharmacy assistant had suggested may be helpful for plantar fasciitis. He confessed to the sports podiatrist that these orthotics were actually quite uncomfortable and he did not wear them consistently.

 

shockwave therapy for plantar fasciitis

Evaluation of plantar fasciitis in the patient

A thorough physical examination was carried out by the sports podiatrist in order to evaluate the severity of the plantar fasciitis. The patient reported a lot of pain around the plantar aspect of the heel as the sports podiatrist palpated his foot. This is the area where the plantar fascia ligament attaches to the heel bone. The sports podiatrist discovered that the patient also had tight calf muscles in both legs, which was limiting the range of motion in the patient’s ankles, hence putting pressure on the plantar fascia. The sports podiatrist informed the patient that his signs and symptoms were consistent with a diagnosis of plantar fasciitis.

Biomechanical assessment for plantar fasciitis

A biomechanical assessment and gait analysis was carried out during the initial consultation as part of the examination for plantar fasciitis. The biomechanical assessment is a useful tool in assisting the sports podiatrist to identify malalignments, imbalances and abnormalities in the patient’s legs and feet as they walk. This information is often used to form the basis of the treatment plan, since plantar fasciitis is often caused by chronic overuse of the plantar fascia ligament due to suboptimal gait. The patient’s arch height and heel position were also measured.

Plantar fasciitis treatment for the patient

A treatment plan was devised for the patient’s plantar fasciitis, with the aim being to reduce inflammation and relieve heel pain, whilst allowing the plantar fascia ligament to heal. The sports podiatrist devised a treatment plan comprised of three main components:

  1. Stretches for the tight calf muscles
  2. Custom-made orthotic inserts
  3. Shockwave therapy.

The patient was prescribed a series of particular stretching exercises by his sports podiatrist. The exercises were particularly selected to assist with increasing flexibility in the calf muscles, which would reduce the strain on the plantar fascia and therefore allow the ligament to heal.

Custom-made orthotics were ordered for the patient. These would assist in the healing of his plantar fasciitis by controlling and supporting the arch of the foot, without putting too much pressure on it. The patient was advised that he would need to wear the orthotics every day for 6-8 weeks. In this time frame, it was expected that his heel pain would resolve and the plantar fascia ligament would begin to heal.

Shockwave therapy treatment was scheduled for this patient once a week for four sessions. Shockwave therapy is a scientifically proven treatment for plantar fasciitis. It works by directing high frequency sound waves into the area, which stimulates blood flow, tissue regeneration and breakdown of scar tissue, whilst also providing almost instantaneous pain relief.

The patient was advised by his sports podiatrist that he would need to refrain from running for the next 3 to 4 weeks whilst he underwent his treatment for plantar fasciitis. The sports podiatrist suggested that in the meantime, he could walk or lightly jog for short intervals only, provided that he followed his prescribed stretching regime closely.

Shockwave therapy for plantar fasciitis treatment: the outcome

The patient returned to the clinic one week after his initial consultation, to have his custom orthotics fitted and to receive his first shockwave therapy treatment. The patient reported immediate pain relief at the cessation of the first shockwave therapy treatment.

The patient’s following shockwave therapy treatment for plantar fasciitis was scheduled for one week later. He informed the sports podiatrist that whilst he’d experienced immediate pain relief following his last treatment, the following morning he had the same severe heel pain. The sports podiatrist reassured him that this was normal and that the therapy can take a number of sessions to take effect. His second shockwave therapy treatment also provided him instantaneous pain relief. At this second therapy session, the patient also reported that he was becoming accustomed to wearing his orthotics. He had been compliant with the stretching regime that the sports podiatrist had prescribed for him.

The patient received two more shockwave therapy treatments for his plantar fasciitis in the following two weeks.

The patient returned to the clinic for a follow-up consultation with the sports podiatrist eight weeks from the initial consultation. The patient reported that his pain from plantar fasciitis had almost completely resolved. The sports podiatrist advised him that he could begin to run again, only over short distance intervals to begin with. He was told to slowly increase his running distance (by no more than around 10% per week).

Please bear in mind that this case study is unique to the individual patient as described. Treatment details should not be taken as general medical advice. If you are suffering with plantar fasciitis or any type of heel pain, you should consult with a qualified sports podiatrist for an accurate diagnosis and individualized treatment plan.

Podiatrist Karl Lockett
Sydney Heel Pain Clinic
93883322
help@sydneyheelpain.com.au

Case Study: Heel Pain in 11 Year-Old Girl – Plantar Fasciitis or Sever’s Disease?

Presentation: Plantar Fasciitis or Sever’s Disease?

An 11 year old girl presented at the Sydney Heel Pain Clinic complaining of heel pain in the bottom of her left foot of approximately 6 months. Her mother had previously taken her to the family’s GP, who suggested that it was likely to be Sever’s disease causing the problem and she was probably too young to have plantar fasciitis, but that further investigations would be required to make a correct diagnosis. The GP suggested that a specialist sports podiatrist should be consulted for the most accurate diagnosis.

The girl was a competitive tennis player, training 3 times a week and competing on weekends, in addition to her regular physical activity sessions at school.

Patient’s Pain Symptoms: Plantar Fasciitis or Sever’s Disease?

The patient reported some pain symptoms that were indicative of plantar fasciitis. She reported that the heel pain was only in the left foot. She had sharp pain in the mornings when she stepped out of bed. When exercising, the girl’s pain was present during her warm ups but then subsided, before becoming very painful again when she finished exercising.

Heel Pain in 11 Year-Old Girl

Examination and Assessment: Plantar Fasciitis or Sever’s Disease?

Whilst some of the girl’s symptoms were consistent with a diagnosis of plantar fasciitis, Sever’s disease would still need to be ruled out. Sever’s disease is a common cause of heel pain in children between 7 and 14 years of age who are physically active. The sports podiatrist carried out a thorough examination, beginning with a comprehensive history-taking. The patient’s feet were examined and palpated; the painful left foot was compared with the normal right foot. The sports podiatrist also assessed the girl’s range of motion and strength in the foot and ankle joint, and the flexibility of her lower leg and foot muscles, ligaments and tendons.

Biomechanical Assessment for Plantar Fasciitis

The sports podiatrist conducted a biomechanical assessment and gait analysis as part of his diagnostic process in determining whether plantar fasciitis was causing this patient’s heel pain. The biomechanical assessment was conducted by placing markers on the patient’s lower legs and recording footage of her walking on the treadmill. The footage was reviewed in slow motion and analysed to detect functional abnormalities and malalignments. Arch height and heel angle were also measured.

Significant Findings of the Examination for Plantar Fasciitis or Sever’s disease

  • The patient felt a lot of pain when the sports podiatrist applied pressure to the plantar aspect of the heel (the area where the plantar fascia ligament connects to the heel bone)
  • There was no pain response when the sports podiatrist squeezed the back of the patient’s heel on the painful foot (growth plate)
  • The patient had tight calf muscles, restricting range of motion in the ankle
  • The patient demonstrated calcaneal eversion, causing over pronation in both feet as she walked.

Diagnosis Confirmed: Plantar Fasciitis

The sports podiatrist informed the patient and her mother that she had plantar fasciitis: a condition that occurs with overuse and persistent strain placed on the plantar fascia ligament. The sports podiatrist said that in his opinion, Sever’s disease could be ruled out due to the absence of pain at the back of the heel (this is the area that is classically sore in cases of Sever’s disease), the fact that the girl reported her pain was not noticeable during physical activity after warming up, and the absence of any swelling or redness.

Treatment for Plantar Fasciitis

Since the patient’s plantar fasciitis diagnosis was confirmed, a treatment plan could be devised and commenced. The sports podiatrist assured the girl’s mother that her plantar fasciitis could be resolved. The main goal of the plantar fasciitis treatment plan was to reduce load , inflammation, relieve the patient’s pain, and facilitate healing of the plantar fascia.

The sports podiatrist gave specific recommendations as to which makes and models of shoes would be most appropriate for the patient to wear during her school day and physical activity sessions. Both of the patient’s feet were strapped with rigid sports tape in order to assist with controlling the load, arch  height and unloading the plantar fascia, allowing it to heal.

The sports podiatrist demonstrated to the patient and her mother the types of exercises she should perform to help her increase the flexibility in her calf muscles. He advised them that this would reduce the strain on the plantar fascia. The patient was instructed to carry out her stretches three times a day, especially before going to bed at night.
It was recommended that the patient take a break from her regular sporting activities for the next 3 weeks while her undergoing her plantar fasciitis treatment.

Plantar Fasciitis Treatment Outcomes

The patient returned to the clinic on a weekly basis for the next three weeks to have her feet strapped and review her plantar fasciitis. She reported that with rest and stretching, and the use of her new shoes at school, she was not in as much pain when she got out of bed in the mornings. The sports podiatrist advised that she could begin incorporating one session of physical activity back in to her weekly routine, and if her pain was not significantly worse, the following week she could add another. The patient was reminded of the importance of strapping her feet as instructed, and making sure to do a correct warm up and cool down.

Please note that this particular case study is unique to this patient. Diagnosis and treatment details are for informational purposes only and should not be taken as general medical advice. If you are suffering with heel pain or you think that you might have plantar fasciitis, you should make an appointment with an appropriately qualified sports podiatrist in order to obtain an accurate diagnosis and individualised treatment plan.

Podiatrist – Omar Mohamad

Sydney Heel Pain Clinic – North Sydney

93883322

 

 

Case Study: Heel Pain from Plantar Fasciitis in 27 Year Old Male

Presentation: Plantar Fasciitis

A 27 year old male presented at the Sydney Heel Pain Clinic, experiencing heel pain in both feet and his symptoms were indicative of plantar fasciitis. The patient advised the sports podiatrist that his heel pain had been present for around 8 months that he could recall. He was overweight (BMI>30) but otherwise had no serious health concerns. He had a mostly sedentary lifestyle, working a desk job five days per week and enjoying video games on the weekends. The patient and his girlfriend had recently adopted a new dog and had begun taking it for walks in the evenings, however the patient often experienced heel pain and it discouraged him to be active. His girlfriend encouraged him to visit the sports podiatrist for a correct diagnosis as she said it sounded like plantar fasciitis.

Heel Pain from Plantar Fasciitis

Patient’s Pain Symptoms: Consistent with Plantar Fasciitis

The patient described heel pain that was consistent with a diagnosis of plantar fasciitis. The patient described his pain as feeling like a stabbing at the base of his heel. His pain was very bad first thing in the morning as he got out of bed. It would subside and feel more like a dull aching after some time of moving around. During the day, he would feel the sharp heel pain again when he would rise from his desk chair after being seated for some time. On the occasions that the patient would walk his dog, his pain would return after he finished exercising. The sports podiatrist informed the patient that his heel pain symptoms were typical of plantar fasciitis.

Plantar Fasciitis Examination and Assessment

In order to confirm his suspicion of plantar fasciitis, the sports podiatrist carried out a thorough examination. He began with a comprehensive list of questions regarding the patient’s pain symptoms, medical history and physical activity habits. The sports podiatrist examined the patient’s feet. The range of motion and strength in the foot and ankle joint were assessed, as well as the flexibility of the patient’s lower leg and foot muscles, ligaments and tendons.

The patient was asked to have an ultrasound to aid the sports podiatrist diagnosis of plantar fasciitis, and to exclude any other injury or abnormality that may be causing the patient’s heel pain. He returned the following week with his results.

Biomechanical Assessment for Plantar Fasciitis

As part of the sport’s podiatrist’s assessment of the patient for plantar fasciitis, he carried out a biomechanical and gait analysis. The in-house treadmill at the clinic was used to perform this. The assessment involved placing some markers on the patient’s lower leg and foot and then recording footage of the patient walking on the treadmill. The sports podiatrist was then able to review the patient’s foot strike in slow motion and detect malalignment or functional abnormalities. Heel angle and foot arch height in the patient’s feet were also measured.

Notable findings of the examination for plantar fasciitis

  • The patient reported strong pain when the sports podiatrist applied pressure to the plantar aspect of the heel (the approximate location where the plantar fascia ligament connects to the heel bone)
  • The patient had poor flexibility in his calf muscles
  • The patient exhibited pes planus (fallen arches)
  • During the biomechanical assessment, the patient exhibited increased foot width and it was determined that there was peak pressure from weight bearing during walking under the longitudinal arch
  • The patient had increased plantar fascia thickness (4.9mm), evident on the ultrasound, confirming a case of plantar fasciitis.

Diagnosis Confirmed: Plantar Fasciitis

The sports podiatrist informed the patient that he had plantar fasciitis: inflammation of the plantar fascia ligament due to chronic overuse.

Treatment for Plantar Fasciitis

Once the patient’s plantar fasciitis diagnosis was confirmed, treatment could begin. The main goal of the treatment for his heel pain was to reduce strain on the plantar fascia and relieve the patient’s pain, while at the same time, allowing the plantar fascia to heal.

The recommended treatment plan comprised five main components:

  1. Stretching the patient’s tight calf muscles
  2. Taping for plantar fasciitis
  3. Custom shoe inserts
  4. Shockwave therapy
  5. Weight loss.

The sports podiatrist demonstrated to the patient which exercises he should perform to help increase flexibility in his calves, which would reduce the strain on the plantar fascia. The patient was instructed to carry out his stretches three times daily, especially before bed.

The sports podiatrist also instructed the patient on how to strap his feet in a way that would support his arches and unload the plantar fascia, providing pain relief and allowing it to heal. Custom shoe inserts were arranged for the patient. The sports podiatrist explained that the custom orthotics the patient would receive would touch and hold the sole of the foot, unloading the plantar fascia and allowing it to heal. The sports podiatrist recommended that the patient should wear his custom orthotics on a daily basis for 6-8 weeks. This would help to relieve his pain in the short term but also allow the plantar fascia to heal in the longer term.

Shockwave therapy was recommended for this patient’s plantar fasciitis treatment. It is an evidence-based treatment for the condition. It has the potential to offer the patient instantaneous pain relief. Shockwave therapy works by stimulating tissue regeneration and encouraging blood flow to the injured or inflamed area. The patient received four shockwave therapy treatments over the course of four weeks.

The sports podiatrist discussed maintaining a healthy body weight with the patient. He encouraged his patient to try to lose some weight, as extra bodyweight puts a lot pressure on the structures in the feet, often causing foot and heel pain. Scientific studies have shown a statistically significant relationship between increased BMI (body mass index), fat mass, and foot pain2. Further studies also demonstrated that patients with chronic plantar heel pain were almost three times more likely to have a BMI of 30 or more1. A change in diet was suggested and the patient was provided with resources for nutrition information. The patient was also advised to begin some low impact exercise (swimming was advised) while his plantar fasciitis healed, until he would be able to walk briskly with his partner and their dog again.

Plantar Fasciitis Treatment Outcomes

The patient completed his course of shockwave therapy treatments for his plantar fasciitis. He reported an immediate reduction in pain on all occasions.

He had been diligent in completing his prescribed exercises. The sports podiatrist advised his patient that he should continue to perform these in the long term so that he could maintain his flexibility, and for general wellbeing.  The patient reported that he found his orthotics comfortable, and that they seemed to be providing him with support in the right places and helping with his pain.

The patient returned for his final check up twelve weeks after his initial visit to the clinic. He reported to his sports podiatrist that on most days he was completely pain free. At that point in time, he was wearing his orthotics on most days thorough the week, and continuing to complete his stretches on a daily basis. The patient had been swimming twice a week and he had begun incorporating walking into his exercise regime three times a week. He had managed to lose a reasonable amount of weight in that time too, which was no doubt helping him to feel better overall.

Please be advised that this case study is unique to this individual patient. Any treatment details mentioned are not intended, nor should they be taken as general medical advice. If you are experiencing heel pain or suspect you might have plantar fasciitis, you should make an appointment with a qualified sports podiatrist for a correct diagnosis and treatment plan.

 

Podiatrist – Omar Mohamad

Sydney Heel Pain Clinic – North Sydney

93883322

 

References:

1Irving, D.B., Cook, J.L., Young, M.A., Menz, H.B., 2007, Obesity and pronated foot type may increase the risk of chronic plantar heel pain: a matched case-control study, BMC Musculoskeletal Disorders, 8, 41.

2Tanamas, S.K., Wluka, A.E., Berry, P., Menz, H.P, Strauss, B. J., Davies-Tuck, M., Proietto, J., Dixon, J. B., Jones, G., Cicuttini, F.M., 2012, Relationship between obesity and foot pain and its association with fat mass, fat distribution, and muscle mass. Arthritis Care Research, 64, 262-268.

 

Case Study: Plantar Fasciitis Treatment in 35 Year-Old Male Runner

Presentation- Plantar Fasciitis?

A 35 year old male presented at the Sydney Heel Pain Clinic requesting plantar fasciitis treatment for his heel pain in both feet, which was more severe in the left foot. He reported that he had been experiencing the pain for at least 4 or 5 months. He was otherwise very fit and healthy. The patient explained to the sports podiatrist that he had recently increased his running distance and training days in preparation for his gym’s annual fun run fundraiser. He reported that he was running 5-7km four days per week before the plantar fasciitis symptoms started.

Plantar Fasciitis Treatment

 

Pain Symptoms Consistent with plantar Fasciitis

The patient’s explanation of his pain, as reported to the sports podiatrist was consistent with that of plantar fasciitis: very sharp, almost like there were nails stuck in his heels. He said that his heel pain was at it’s worst first thing in the morning, and that he often hobbled for his first few steps as he got out of bed- also a hallmark of plantar fasciitis. After a few minutes of walking around, the pain would subside and feel more like a dull aching. When asked about how his heels felt when running, the patient told the sports podiatrist that he had been performing five minutes of stretching before his runs, and he felt that after the first 5-10 minutes of running, his feet felt warmed up and the plantar fasciitis pain was bearable. However, he was most concerned about the fact that once he’d finished his run, the heel pain would become so severe that he would end up limping back to his car.

Plantar Fasciitis Home Remedies Tried by the Patient

The patient told the sports podiatrist that he had been doing some reading about plantar fasciitis online, in some runner’s forums, and based on the information he’d read, he had been trying some home remedies to relieve his heel pain. He had been icing his feet in a tub of ice and water in the evening. He had visited his local pharmacy where he told the assistant that he suspected he may have plantar fasciitis, and he was given some generic over-the-counter orthotics to try, which he placed inside his work shoes (casual shoes) on a daily basis. He said the orthotics made walking uncomfortable hence he spent a long time at his desk. The patient was taking ibuprofen on average, 2-3 times per week on occasions when his heel pain was so bad after his morning run that it bothered him throughout his working day.

A friend from the gym recommended to the patient that he visit a sports podiatrist for a correct diagnosis and treatment, as she had suffered with plantar fasciitis in the past as well.

Examination to Assess Patient’s Plantar Fasciitis

The sports podiatrist carried out a thorough physical examination in order to assess the severity of the plantar fasciitis. On palpation, the patient reported a lot of pain around the plantar aspect of the heel, in the area where the plantar fascia ligament attaches to the heel bone. The sports podiatrist’s examination also revealed tight calf muscles in both legs, which was limiting the range of motion in the ankles of the patient. The patient was advised that his clinical signs and symptoms were consistent with plantar fasciitis.

Biomechanical Assessment for Plantar Fasciitis

As part of the examination for plantar fasciitis, the sports podiatrist carried out a biomechanical assessment and gait analysis on the in-house treadmill. Treatment for plantar fasciitis is often based around the findings of the treadmill assessment. To perform the assessment, markers were applied on the patient’s lower leg and foot and the camera was used to record footage of the patient running on the treadmill. Foot strike was then analyzed in slow motion and abnormalities were noted. Arch height and heel position were measured.

Commencement of Treatment for Plantar Fasciitis

The aim of the treatment plan for the patient’s plantar fasciitis was to reduce inflammation and relieve his heel pain, whilst allowing the plantar fascia to heal. The treatment plan prescribed by the sports podiatrist comprised three main components:

  1. Stretches for the calf muscles
  2. Prescription (custom-made) orthotics
  3. Shockwave therapy

The patient was prescribed a series of stretching exercises by his sports podiatrist. The exercises were particularly selected to assist with increasing flexibility in the calf muscles therefore allowing the plantar fascia to heal. The sports podiatrist explained the importance of following the exercise regime closely so that the patient would not worsen his plantar fasciitis.

In order for the plantar fasciitis to recover, the patient was advised that he would have to wear some custom-made orthotics in order to appropriately support the arch of the foot without placing undue pressure on it. The sports podiatrist advised the patient to wear the orthotics every day for 6-8 weeks, which would relieve his heel pain in the shorter term and allow the ligament to heal in the long term.

The patient was scheduled to receive a shockwave therapy treatment once a week for four sessions. Shockwave therapy is a clinically proven treatment for plantar fasciitis. It can provide almost immediate relief from heel pain, whilst facilitating tissue regeneration and stimulating blood flow to the area.

The sports podiatrist advised the patient that whilst he was undergoing treatment for the next 8-12 weeks, he should not run the distances that he had been covering previously. In the meantime, he was suggested to walk and jog for short intervals only, making sure to warm up correctly as instructed prior to exercising. Cooling down with appropriate exercises was just as important, followed by applying ice packs to the feet following exercise. The patient was compliant and happy to do so, as he still had plenty of time to train for his fun run!

The patient was advised, and opted to switch his minimalist-style runners for a pair of appropriate Asics Gel Fortitude running shoes, as recommended by his sports podiatrist. (These were a match for his foot type / shape / boy weight)

Plantar Fasciitis Treatment Outcomes

A week after the initial consultation, the patient returned to the clinic to have his custom orthotics fitted and to receive his second shockwave therapy treatment. Immediately following the treatment, the patient reported that he experienced relief from the heel pain.

The following treatment for his plantar fasciitis was scheduled for one week later. This next treatment also provided instantaneous pain relief. The patient reported that he was becoming used to wearing his orthotics and he felt that he was tolerating them well. He had so far been compliant with the exercise regime that the sports podiatrist had prescribed, and the heel pain from his plantar fasciitis was reducing.

The patient received two more shockwave therapy treatments for his plantar fasciitis in the following two weeks.

A follow-up consultation and assessment was performed by the sports podiatrist when the patient visited the clinic again 8 weeks later. The patient was very pleased to report that his heel pain had completely resolved. His plantar fasciitis had been treated successfully. He was advised that he could begin to run again, starting with short distance intervals of running incorporated with the current walking/jogging. He was instructed to gradually build his distance up by no more than around 2-3% per week, and to contact the sports podiatrist in the event of any returning heel pain.

Please note that this case study is unique to the individual patient as described. Any mention of treatment should not be taken as general medical advice. If you have heel pain or suspect you may have plantar fasciitis, you should consult with a qualified sports podiatrist for a full assessment and diagnosis.

Podiatrist: Rami Ghorra

Sydney Heel Pain Clinic

Case Study: Heel Pain from Plantar Fasciitis in 38 Year-Old Female

Presentation- Plantar Fasciitis?

A 38 year old female presented at the Sydney Heel Pain Clinic with heel pain in her right foot, consistent with plantar fasciitis. She reported that she had been suffering with heel pain for around 6 months. The patient told the sports podiatrist that she had joined her local health club about 6 months ago and she was participating in step aerobics classes 2-3 times per week. The patient was slightly above a healthy BMI but reported that she had been steadily losing weight (she had already lost 8kg in 6 months). Occasionally (approximately once a week) she would have cramping in her calves in the evening after a big day on her feet. She was otherwise healthy. The patient was a busy mum of 3 kids, and she was concerned that her heel pain would get worse and that the plantar fasciitis would stop her from doing things with her children.

Pain Symptoms Consistent with Plantar Fasciitis

The description of her heel pain was consistent with plantar fasciitis. She described that her pain was worst first thing when she stood up out of bed. The pain felt like a stone in her heel. She said that the heel pain would subside and feel more like a dull ache after a few minutes of walking around. The patient told the sports podiatrist that her pain was manageable whilst she was exercising, but she was often so sore following her aerobics class that she would roll her foot over a frozen water bottle for relief and then spend some time lying on the couch. This provided her some temporary relief but when she stood up, she would feel the heel pain from the plantar fasciitis again.

Heel Pain from Plantar FasciitisPlantar Fasciitis Home Remedies Tried by the Patient

The patient told the sports podiatrist that she had discussed her heel pain only very briefly with the GP a couple of months ago, and the GP had mentioned that she may have plantar fasciitis, though she never returned for a proper diagnosis or treatment. She had searched ‘plantar fasciitis’ on the internet, and based on the information she’d found, she had been trying some treatments at home. The patient had been using a frozen water bottle to ice-massage her sore foot. She was also performing some stretches for plantar fasciitis that she had watched in a YouTube video, but admitted that she often forgot to do these on a regular basis. The patient had seen an advertisement on the internet about some plantar fasciitis socks, but she was unsure whether these would work. She reported to the sports podiatrist that very occasionally she would take ibuprofen if the heel pain from the plantar fasciitis became severe.

The patient’s husband recommended to her that she visit a sports podiatrist for a correct diagnosis and treatment, as he was concerned that she was becoming increasingly sore.

Examination to Assess Patient’s Plantar Fasciitis

The sports podiatrist carried out a thorough physical examination in order to confirm the diagnosis and assess the severity of the plantar fasciitis. As the sports podiatrist palpated the sore foot, the patient reported a lot of pain in the central area of heel. There was also some pain in the plantar area, where the plantar fascia attaches to the heel bone. She was able to successfully perform a single leg heel raise on the affected leg without notable pain. The sports podiatrist performed some further physical tests on the range of motion in the foot and ankle joint, and on the muscles, ligaments and tendons in the lower leg and foot. The sports podiatrist’s examination revealed tight calf muscles in the patient’s legs, but more so in the right leg. No further abnormalities were detected.

The patient was notified that her clinical signs and symptoms were consistent with a diagnosis of plantar fasciitis, but reassured her that her condition was treatable.

Biomechanical Assessment for Plantar Fasciitis

During the physical examination for plantar fasciitis, the sports podiatrist also conducted a biomechanical assessment and gait analysis on the in-house treadmill. Markers were placed on the patient’s lower leg and foot and the footage of the patient running on the treadmill was recorded. An analysis of foot strike was then carried out in slow motion. Arch height and heel angle were measured.

Footwear Assessment for Plantar Fasciitis

Following the examination and biomechanical assessment, the sports podiatrist assessed the patient’s footwear. The patient had a pair of branded minimalistic-style running shoes, which she was using for step aerobics classes and also during running her daily errands. It was determined that her current runners were not providing sufficient support for her foot. This is likely to have been a major contributing factor in the development of the patient’s plantar fasciitis.

Commencement of Treatment for Plantar Fasciitis

Treatment for plantar fasciitis is often based around the findings of the treadmill assessment and physical symptoms. The aim of the treatment for this particular case of plantar fasciitis was to reduce inflammation and relieve pain, whilst at the same time allowing the plantar fascia ligament to heal.

The sports podiatrist devised a treatment plan with three main components:

  1. Change in footwear
  2. Strapping
  3. Stretches for the calves and plantar fascia
  4. Shockwave therapy

The patient was shown some stretching techniques by her sports podiatrist. The exercises were selected in order to help with increasing flexibility in the calf muscles- which would also help with the patient’s cramping- and releasing the foot and ankle, and therefore allow the plantar fascia to heal. The sports podiatrist explained to the patient that she should set an alarm to remind her to complete her exercises at intervals throughout the day.

In order for the plantar fascia to recover, the patient was recommended to purchase a new pair of shoes. This particular patient was advised that for her foot type, the Brooks Adrenaline GTS would be most appropriate to adequately support the architecture of the foot without placing any undue pressure on it.

Shockwave therapy is a scientifically proven treatment for plantar fasciitis. It can provide instant pain relief, encourages tissue regeneration and stimulates blood flow to the area. The patient was scheduled to receive four shockwave therapy treatments over the course of four weeks. Rigid sports tape was applied to the affected foot and was to be re applied at each session.

The sports podiatrist recommended to the patient that during her treatment for the next 6 weeks, she should not participate in step class. She was advised and choose another activity instead that would not be high-impact for her feet, making sure to warm up prior to exercising. Some options were aqua aerobics, swimming, or upper-body boxercise.

Plantar Fasciitis Socks?

With regards to the patient’s question regarding plantar fasciitis socks for treatment, the sports podiatrist advised her that there is a lack of evidence available regarding their efficacy. The patient would be receiving scientifically proven methods of treatment for her plantar fasciitis, so there would be no need to purchase plantar fasciitis socks.

Plantar Fasciitis Treatment Outcomes

The patient received her first shockwave therapy treatment on the day of consultation. She tolerated the treatment well. She reported that she experienced pain relief immediately following her treatment.

The following treatment was one week after the first. This second treatment also provided the patient instantaneous pain relief. The patient also reported that she had been completing the exercises that the sports podiatrist had prescribed.

In the following two weeks, the patient received two more shockwave therapy treatments for her plantar fasciitis.

A follow-up consultation was scheduled by the sports podiatrist for two weeks after the final shockwave therapy treatment. The patient was pain free. She reported that her new shoes felt so supportive on her feet, and she had been compliant with the exercise program that her podiatrist has suggested for her. She was advised that she could return to her step aerobics class, but should begin by using the lowest step and following the low impact option, if the class instructor gave one. If she was still pain free for 2 weeks, she could progress.

Please be advised that this case study is unique to the individual patient. Any reference to treatments should not be taken as general medical advice. If you have heel pain or you suspect you may have plantar fasciitis, you should consult with a qualified sports podiatrist for an assessment and correct diagnosis.

Book online – https://www.sydneyheelpain.com.au/book-online/

 

Podiatrist – Fatmeh Abdi

Sydney Heel Pain Clinic

93883322

Case Study – Heel Pain from Plantar Fasciitis or Heel Stress Fracture in 30 Year-Old Martial Artist

Presentation- Possible Plantar Fasciitis?

A 30 year old female presented at the Sydney Heel Pain Clinic with heel pain in her left foot and symptoms indicative of plantar fasciitis. The patient told the sports podiatrist that she’d had trouble with heel pain for around 18 months, however it had become increasingly painful in the last 3 or 4 months. The patient had been a regular participant in kickboxing for most of her adult life, but recently she had increased her training sessions in preparation for an upcoming tournament. Her sport required her to train and compete in bare feet, with no option to wear shoes. She was otherwise very fit and healthy. The patient was a busy mum with two children, so naturally she was concerned about her heel pain worsening and getting in the way of her day-to-day routine.

Pain Symptoms Indicative of Plantar Fasciitis

The patient’s description of her heel pain was largely indicative of plantar fasciitis. She mentioned that the pain was worst first thing when getting up out of bed, and felt like a pebble or stone in her heel. After some time being up and about, the pain would be less severe. When asked about her pain during training, the patient told the sports podiatrist that when she trained at her regular gym, it was manageable. She went on to tell the sports podiatrist that her gym was well-equipped with foam matting, however she had recently been having some personal training sessions at another gymnasium, where the floor was harder rubber matting. Whilst training on the rubber mats, her pain was worse, and immediately after those sessions, she found herself hobbling back to her car. As part of her routine, she was also running three 5km runs a week. She had recently invested in a pair of quality Brooks running shoes, which she chose based on her online research. The patient told the sports podiatrist that whilst wearing the shoes, she was able to run reasonably comfortably. The sports podiatrist felt that the patient’s symptoms and signs were pointing towards a plantar fasciitis diagnosis, however given the high impact of the physical activity the patient was participating in, he was also wondering whether she may have a heel stress fracture.

Plantar Fasciitis Home Remedies Tried by the Patient

The patient told the sports podiatrist that she had researched different types of heel pain on the internet, and based on the information that she had discovered, she had been trying some treatments for plantar fasciitis at home. She had been icing her feet with ice packs. She was also performing some calf stretches for plantar fasciitis that she had read about. The patient was interested in using sports tape for strapping for plantar fasciitis, but was unsure of how to do this correctly.

The patient finally decided to visit the sports podiatrist for a correct diagnosis and treatment because she was worried that her heel pain was becoming increasingly worse. She worried that it may prohibit her from continuing to train and compete, or stop her from being able to keep up with her young family.

Examination to Diagnose Plantar Fasciitis or Heel Stress Fracture

The sports podiatrist was suspicious of plantar fasciitis, with a differential diagnosis of a heel stress fracture. As such, he carried out a detailed physical examination in order to confirm his diagnosis. Upon palpation of the sore foot, the patient reported severe pain in the plantar heel area, around where the plantar fascia attaches to the heel bone. There was no notable swelling, nor was there any pain around the outside of the heel. The patient was able to perform a single leg heel raise on the sore leg without pain. The sports podiatrist also assessed the range of motion in the foot and ankle joint. The flexibility of the muscles, ligaments and tendons in the lower leg and foot was examined. The sports podiatrist’s investigations revealed tight calf muscles in the patient’s legs, but more so in the left foot.

Medical Imaging for Plantar Fasciitis Diagnosis

The sports podiatrist told the patient that while her clinical signs and symptoms were consistent with a diagnosis of plantar fasciitis, he would like her to have an ultrasound and xray. The ultrasound would allow the podiatrist to confirm a true case of plantar fasciitis, and also to exclude any other soft tissue injuries that may be contributing to the pain. The xray would determine whether or not a heel stress fracture was present.  (Post 6 weeks since onset of pain)

Biomechanical Assessment for Plantar Fasciitis

A biomechanical assessment and gait analysis on the in-house treadmill were also conducted as part of the assessment for plantar fasciitis. This involved placing markers on the patient’s lower leg and foot and then recording footage of the patient running on the treadmill. This allowed for an analysis of foot strike in slow motion. The patient’s medial foot arch height and heel angle were measured.

Footwear Assessment for Plantar Fasciitis

Following the biomechanical assessment, the sports podiatrist assessed the patient’s footwear. The new Brooks runners that the patient had purchased were indeed an appropriate choice for her feet and provided adequate support. This was likely why the patient was reasonably comfortable during her runs as opposed to when undertaking her barefoot training.

Diagnosis: Plantar Fasciitis

The patient returned to the clinic the following week with her images, so that the sports podiatrist could review them and make a diagnosis of plantar fasciitis or otherwise. The ultrasound confirmed a definite case of plantar fasciitis, with a plantar fascia thickness of approximately 7mm in the affected foot. The xray confirmed that there was no heel fracture present.

Heel Pain from Plantar Fasciitis or Heel Stress Fracture

Commencement of Treatment for Plantar Fasciitis

Once a diagnosis of plantar fasciitis was confirmed, treatment could begin. Treatment for plantar fasciitis is partly dependent on the results of the treadmill assessment. The aim of this patient’s treatment for plantar fasciitis was to reduce stress and load on the plantar fascia and relieve her pain, whilst allowing the plantar fascia ligament to heal at the same time.

The sports podiatrist recommended a treatment plan with three main aspects:

  1. Stretching for the patient’s tight calf muscles
  2. Shockwave therapy
  3. Strapping

The patient was shown some stretches for her tight calves by her sports podiatrist. Increasing flexibility in the calves would help to relieve her pain and allow healing by unloading the plantar fascia. The sports podiatrist recommended that she complete her stretches three times daily, and especially prior to and following her training sessions – with her foot in a supinated position

Shockwave therapy is a clinically tested and proven treatment for plantar fasciitis. It often provides the patient with immediate pain relief, stimulates tissue regeneration and encourages blood flow to the targeted area. Over the course of the following four weeks, the patient would receive four shockwave therapy treatments for her plantar fasciitis – up to a maximum of 6.

In order for the plantar fascia to recover, the patient was recommended to stop training on the hard rubber matting. She was advised on how to strap her feet correctly in a way that would support her foot arches day to day, and also for the training sessions that she was going to be doing on the foam mats.

The sports podiatrist recommended to the patient that since she would be undergoing treatment, she should not participate in barefoot kickboxing for the net 6 weeks. The patient was able to liaise with her kickboxing coach and sports podiatrist together, to formulate a training regime including hand-only boxing (wearing her runners) and swimming, so that it would not be so high-impact for her feet. This also freed up some time in the patient’s training schedule, allowing her to incorporate two yoga sessions a week, which also assisted her flexibility ( No downward dogs )

Plantar Fasciitis Treatment Outcomes

The patient received her first shockwave therapy treatment on the same day as her follow-up consultation. The treatment was well tolerated. She described pain relief immediately following her treatment.

The next treatment was one week after the first. This second treatment also gave the patient immediate pain relief. The patient also reported she was feeling good about her training routine and that she felt her pain was generally improving.

In the next two weeks, the patient received two more shockwave therapy treatments for her plantar fasciitis.

The sports podiatrist scheduled a follow-up appointment with the patient two weeks after her fourth shockwave therapy treatment. The patient said that her heel pain had almost subsided completely. At this appointment, she was advised that she could return to kickboxing, however she would need to be vigilant in warming up adequately and strapping her feet. She was told to limit kickboxing to one session a week initially, and she would add another session every fortnight provided she was still pain free.

Please be advised that the case study described above is unique this individual patient. Treatment details are not intended to be, nor should they be taken as general medical advice. If you are experiencing symptoms of plantar fasciitis, or heel pain you should consult with a qualified sports podiatrist for a correct diagnosis.

 

Podiatrist – Omar Mohamad

Sydney Heel Pain Clinic – North Sydney

93883322

 

https://www.sydneyheelpain.com.au/book-online/

 

 

Achilles Tendon Pain

CASE STUDY OF ACHILLES TENDON PAIN

A 37-year-old male in good health, attended the Sydney heel pain clinic complaining of Achilles tendon pain in his left foot. His problem had been ongoing for approximately six months and he reports to the sports podiatrist that over the last three weeks it got much worse. The Achilles tendon pain was limited to the left ankle only and did not affect his right side. The discomfort he felt ran along approximately 3 cm of the Achilles tendon shaft, just above the heel bone itself. This patient was a keen walker and enjoyed approximately 5 or 6 km walks with his dog each weekend. During the week, he would carry out shorter walks with his wife and his dog but would also experience the Achilles tendon pain regardless. He described a significant stiffness through the left ankle in general and found each morning when rising from bad to be problematic. As is often the case, following his morning routine including a hot shower, the Achilles tendon pain subsided significantly and he was able to continue with his day-to-day duties. He reports to the sports podiatrist that following long drives or extended periods of being seated, the Achilles tendon pain would return when he stood up or started walking. This gentleman explained to the podiatrist that he would occasionally use anti-inflammatory medication and this would reduce the symptoms. He had also decided carry out some home remedies including stretching and loading exercises, but he found that these increased symptoms. The Achilles tendon pain would subside slightly following the exercises but would return with increased intensity shortly afterwards.

ASSESSMENT OF ACHILLES TENDON PAIN

The sports podiatrist carried out a routine examination of the left ankle and noted severe Achilles tendon pain on palpation when finger pressure was applied. The patient was advised that he had a condition commonly known as Achilles tendinitis and that it may be complicated by a bursitis. The insertion of the Achilles tendon at the posterior aspect of the heel bone was unremarkable and did not induce pain or discomfort on palpation. The plantar fascia was also intact and nonproblematic. The patient was informed that the cause of his Achilles tendon pain was a classic Achilles tendinitis.

WHAT CAUSES ACHILLES TENDON PAIN?

Upon examination of this patients exercise shoes it became apparent that these were the cause of his Achilles tendon pain. The shoes were old and extremely worn and had softened considerably. His shoes were providing some form of comfort and a mild form of cushioning but lacked support and control. Due to the lack of support there was an excessive amount of pronation and hyper mobility of his left foot inside the shoe during gait. This would have increased the load on the Achilles tendon and caused significant stiffness through the lower calf.

TREATMENTS FOR ACHILLES TENDON PAIN

In order to reduce the Achilles tendon pain in this patient the sports podiatrist informed the patient that his footwear must be changed immediately. The patient was measured and fitted with a new pair of ASICs gel fortitude in the clinic and was observed on the treadmill. Video footage was recorded and replayed and the new shoes were approved. The sports podiatrist demonstrated and executed with the patient, standing calf stretches with the foot supinated. The patient was asked to apply ice to the posterior aspect of his ankle on a daily basis in order to reduce irritation and inflammation, and to minimise the Achilles tendon pain.

This patient returned for a follow-up at four weeks and reported to the sports podiatrist that his Achilles tendon pain had improved significantly. He advised the practitioner that there was some residual stiffness each morning when rising from bad but that the sharp stabbing sensations and the throbbing pain had gone completely. This patient had been compliant with the application of ice packs on a daily basis and had performed regular calf stretching, all of which helps to reduce the Achilles tendon pain.

If you are suffering with Achilles tendon pain or if you think you have Achilles tendinitis please do not take the information contained in this case study as medical advice.

You should consult with a suitably qualified healthcare practitioner. The sports podiatrists at the Sydney heel pain clinic have a special interest in Achilles tendon pain and appointments can be made on the following phone number: 02 9388 3322

achilles tendon pain

Plantar Fasciitis Massage

Does Plantar Fasciitis Massage Help?

A 63-year-old female presented to the Sydney heel Pain clinic requesting plantar fasciitis massage for her painful right heel. She had been experiencing severe heel pain for more than 10 months and was becoming increasingly frustrated with her condition. She informs the sports podiatrist that she has experienced plantar fasciitis before and that it took more than two years to subside. She had read about the benefits of plantar fasciitis massage and had been treating herself at home for the last three months. She had been applying ice packs to the base of the heel and had also been rolling her foot on a frozen water bottle. None of the treatments were providing long-term relief but she did inform the podiatrist that there was short-term relief following the application of the ice packs. A work colleague informed the patient that plantar fasciitis massage is beneficial in the long term treatment of this heel pain condition. She had previously experienced soft tissue release through the calf muscle and had been using a foam roller at home in order to release the calf muscles. However, she had not paid a visit to a practitioner in order to receive specific plantar fasciitis massage.

Limited Research Around Plantar Fasciitis Massage

The sports podiatrist informed the patient that there was limited research to suggest that plantar Fasciitis massage is actually a beneficial or reliable treatment option for the condition. She was advised that a detailed assessment must be carried out in order to determine the cause of her condition and therefore which treatment or treatments would be beneficial for her particular set of circumstances. Ordinarily, the patients attending the Sydney heel Pain clinic receive other treatments that do not include plantar fasciitis massage. However, once the biomechanical assessment had been carried out a decision would be made.

The sports podiatrist performed a detailed physical assessment in order to diagnose and confirm plantar fasciitis. Firm finger pressure was applied to the plantar fascia at the attachment point on the base of the heel. Pressure was also applied through the mid arch of the foot along the distal fibres of the plantar fascia. The patient confirmed significant pain on palpation of these key points confirming plantar fasciitis.

The biomechanical assessment also revealed that the patient was using footwear that was way too soft and non-supportive. Part of her treatment plan would involve new shoes. The sports podiatrist was able to prescribe and recommend very specific makes and models of day to day shoes and running footwear. It was also revealed that the patient demonstrated restricted range of motion through the ankle joint due to tight calf muscles.

Plantar Fasciitis Massage Not Required

The sports podiatrist advised the patient that there would be no need to perform plantar fasciitis massage due to the fact that there were other contributing factors that would be addressed. Stretching the calf muscles and supporting the plantar fascia with new robust shoes would allow the plantar fascia to heal. The patient was quite pleased with these findings and agreed to this simple treatment plan. She was advised that if she continued to perform plantar fasciitis massage herself at home, then she may risk irritating the fascia, and this may cause further pain.

The sports podiatrist also explained that there were several other treatments that could be tried if there was little or no improvement. Shockwave therapy, 3-D orthotics, strapping and the use of an immobilisation boot if necessary. The patient was reviewed after three weeks and reported improvement of approximately 70%. She was happy to continue with the calf stretching and the use of the new shoes which were providing excellent support and control. She informed the sports podiatrist that she had not been carrying out plantar fasciitis massage and would be happy to continue in this fashion.

Practitioner: Karl Lockett , Sydney Heel Pain Clinic

Plantar Fasciitis Massage

Plantar Fasciitis Diagnosis

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

  1. Calf muscles release and stretch.
  2. Shock wave therapy.
  3. 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

help@sydneyheelpain.com.au

02 93883322

 

Plantar Fasciitis Diagnosis

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Plantar Fasciitis Shoes

Do Plantar Fasciitis Shoes Exist?

A new patient undergoing plantar fasciitis treatment arrived at Sydney heel pain clinic requesting advice relating to the treatment of his condition, and wanted to know if there was such thing as plantar fasciitis shoes. And if so, which make or model would be best or most appropriate for his heel pain. This otherwise healthy individual had been experiencing plantar heel pain, and medial heal pain for more than 12 months. He was disappointed in the treatment he had received to date as none of it had been helpful. Typical of patients in his circumstances, this gentleman was proactive and carried out much research himself, and this led him to several websites that claimed to sell plantar fasciitis shoes. This patient had received 12 weeks of physiotherapy for his plantar fasciitis and had been advised to carry out stretching techniques and other forms of self-treatment at home. The physiotherapist had performed deep tissue massage through the arch of the foot and around the base of the heel and had also performed release techniques through the calf muscle. The physiotherapist had also mentioned plantar fasciitis shoes and offered to sell the patient a pair of MBT rocker bottom shoes for his condition. The patient tried on the shoes in the clinic but informed the physiotherapist that he found them to be unstable and made him feel off balance. To this end the patient did not proceed with the plantar fasciitis shoes but instead carried on with treatment. The physiotherapist advised the patient that without proper plantar fasciitis shoes his condition may take longer to heal. The patient reported to the sports podiatrist that the 24 hours that followed the treatment with the physiotherapist were less painful. For this reason he continued with the treatment. However, the benefits from the treatment were short-lived and the patient felt like he was stuck on a medical merry-go-round.

Plantar Fasciitis Shoes

This particular patient returned to his GP and requested further investigation for his plantar fasciitis. He mentioned plantar fasciitis shoes to the doctor but the GP confessed not to be experienced in this area and was not able to advise. The GP did follow instruction from the patient and organised an MRI of his painful right foot. The MRI report conclusively revealed plantar fasciitis, without the presence of heel spur. With this knowledge in mind the patient decided to continue being proactive in search of a successful remedy for his troublesome heel pain. What he was experiencing is not uncommon as many practitioners do struggle with plantar fasciitis treatment due to the wide variety of solutions that are readily available.

Evidence of Plantar Fasciitis Shoes

There does not seem to be any research relating to the effectiveness of plantar fasciitis shoes, and those companies that promote them do not have sufficient evidence to back up the theory.

This patient reported to the sports podiatrist that his heel pain was significant every single morning when rising from bed. This is common for plant fasciitis and it is rare that patients with this condition do not experience this start up pain. The pain can also be very noticeable after long periods of being seated. While this patient did not possess any specific plantar fasciitis shoes he did report to the podiatrist that he would step into a pair of running shoes every morning to help with the pain. Please note that functional running shoes will often assist in supporting the foot, and while they are not technically plantar fasciitis shoes they can help with the symptoms due to the high level of support. Once again there is no evidence surrounding the efficacy of running shoes in the treatment of plantar fasciitis.

Physical Examination – Did this Patient Require Support from Plantar Fasciitis Shoes

The sports podiatrist carried out a routine physical examination in order to diagnose the plantar fasciitis and discuss treatment options. The patient was informed that his signs and symptoms were definitely consistent with plantar fasciitis and this was backed up by the report from the MRI. The podiatrist advised the patient that the single most important factor in treatment of his condition was support for the plant fascia. The podiatrist also informed the patient that while he was not aware of any particular plantar fasciitis shoes, he should be given high levels of support from footwear in general. This could be backed up by the fact that the patient did in fact feel much better when wearing his Asics running shoes. The podiatrist explained to the patient that other forms of support would prove to be more beneficial such as prescription orthotics, strapping techniques and the use in extreme circumstances of immobilisation boots. The patient was informed that the high level of support allows the plantar fascia to rest and heal naturally without the use of medication or injection therapy.

This patient was booked in for a follow-up visit so that his treatment and full assessment could commence. This would involve the use of treadmill assessments and further physical and biomechanical assessments which would help to determine treatment. The patient was not prescribed plantar fasciitis shoes nor was he recommended to purchase these from any other place.

Once again, the podiatrist at the Sydney Heel Pain Clinic are not aware of any proven plantar fasciitis shoes that can assist in the treatment of the condition.

 

Written by Karl Lockett

Podiatrist

 

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