Hi there! Welcome to this tutorial on plantar fasciitis. My name is Karl Locket. I’m a sport podiatrist in Sydney, Australia. I trained in Manchester in the UK. My area of interest is plantar fasciitis. I’ve been working with this condition for approximately 10 years. So if you are watching this video, you’re probably suffering from heel pain or plantar fasciitis. I’m going to run through a few things today and explain to you a very successful way of treating this condition. And also run through a few other things, a few reasons why I think a lot of different treatments have failed to help the condition itself.
OK, so first of all, a bit of a background on the plantar fascia itself. The Plantar fascia is a large ligament type structure running through the sole of your foot . It runs from the base of your heel and through the arch of your foot, and attaches into the base of your toes up at this end here. It’s quite a large structure. It’s responsible for some of the strength and stability of your foot. Now, if you are suffering with plantar fasciitis, you probably get pain first thing in the morning when you take your first few steps, pain after you’ve been sitting down for a given period, you probably hobble a around for a few steps, then that pain probably drops off a little bit, allowing you to walk a bit more easily. But you probably find the pain last the all day , and you get shooting pains in your foot. A lot of patients will describe this condition as a feeling of stone bruise sensation or a pebble in your shoe right underneath your heel.
Now the treatment that I have the most success with, with plantar fasciitis is with orthotic therapy. But only because I apply some very specific principles into the design of my orthotic themselves. Ok, you may think that all orthotics are the same, but this is definitely not the case. They can vary dramatically. Even if they look the same in appearance, they work differently. It’s like a pair of spectacles.You might have a few different glasses on a table. They all look the same but you put each pair on individually and they work very differently. And the same principles apply with orthotics. I’m just going to outline some basic principles of orthotic therapy, principles which I find are often overlooked. And afterwhich, you’ll probably understand why some orthotics work, while a lot of orthotics fail to help plantar fasciitis.
When an insole is designed, there are two areas of that insole that can create support for the foot. One is the arch contour of this insole, very obvious and traditional. The other is a wedge, a bit like a door stopper that’s place around the inside heel area of the insole. Now, your individual foot function will determine which of these two areas, areas of support you actually need. You might need an insole with a good strong amount of arch support and a tiny bit of heel wedging, or you might need an insole that has a very low and gentle arch support but a lot of heel wedging instead. Okay, let me give you two examples to try and help explain these principles. First of all, I use the example of a foot which collapses . So if the arch of your foot drops or your foot collapses when you walk, then you should not be using orthotics that are designed with arch support. This type of orthotic will push up against the arch of your foot against the fascia, as the arch collapses and will feel like you’re walking on a tennis ball. It will put too much strain on the arch and on the fascia and will aggravate the condition. So this foot type we find will benefit much more from an orthotic that’s designed with gentle arch support. Just a little bit of contact through the arch of your foot but will control the foot instead with that little wedge, with the little door stopper that’s positioned around the inside heel area of the orthotic instead. So basically we are going to support this foot without pushing against fascia.
Now for the opposite foot type, which is the foot with the higher arch, that doesn’t collapse very much. So this foot type will benefit from the opposite type of orthotic that is designed with the very full arch and a minimal amount of heel wedging. So this orthotic must be designed very accurately so that the arch height of the orthotic marries exactly with the arch heightof the patient’s foot. So from a practitioner point of view, it’s really important that we get very accurate foot mold or foot scan and get a very accurate measurement of the patient’s arch height. So that the arch contour of the orthotic makes good contact with the arch of the patient’s foot. Therefore, supporting the fascia and relieving the stress and strain from the fascia itself.
So from these two basic principles that are outlined here, now, you’ll probably see that orthotic therapy is not as simple as it first may seem. And just because you have your feet molded by a podiatrist or a practitioner, it doesn’t mean that you are going to get the right orthotics for your feet. It really is all about the design especially with a condition like plantar fasciitis that is very stubborn and very painful .Now, there are lots of other variables in orthotic therapy as well and these principles that I’ve got through here, are just the tip of the iceberg. So my advice to you here is to do your research and find a good qualified sports podiatrist who specializes in orthotic therapy and I’m preferably one who has had some good success in treating plantar fasciitis.
Now, within our practice, plantar fasciitis is obviously the most common condition that we treat and we always abide by these principles of orthotic therapy because we see how beneficial it is to our patients . When we fit these patients with this right type of orthotics inside their shoes, they are usually cured and free from pain within a matter of weeks.
So my point here is to find out what foot type you are and make sure you wear the right type of orthotic for your foot type. Now, obviously the best way for you to do this is to visit a good qualified sports podiatrist and have them video your feet as you walk on a treadmill and make all of the necessary measurements.
Now there are lots of different home remedies that you might have tried to help with your plantar fascia problem. You might have tried rolling your foot on a frozen bottle of water , rolling your foot on a golf ball, pulling back on your toes, pushing your toes against the wall , hanging your heel off a step, lots of these different remedies that are very very popular. My advice to you is to be very very careful and perhaps refrain from these remedies. And I know that’s a bold statement because these treatments are very very common. However, I have found a lot of patients that these remedies further irritate the fascia. Rolling your foot on a hard object can put more pressure on the fascia and irritate it and certainly stretching the sole of your foot can further strain the fascia and cause it to pull more on the base of your heel. So even if these remedies give you a little bit of relief in the short term, which is very common, there is the potential that they’re aggravating your foot in the long term. So just be very careful with these remedies. Likewise, if you‘ve tried using arch supports in your shoes, you may have also found that these have aggravated your foot and that’s the same reason why. The arch supports are designed to push up against the arch of your foot, which really means they are pushing against that plantar fascia. Again, that can put more pressure on the fascia itself,and just cause a bit more irritation. So just be careful with that too. So although orthotic therapy is often the quickest and the most successful way to treat plantar fasciitis, it’s not always essential. With some patients,we can give you some very specific stretches to do when we can get you to avoid those home remedies that we spoke about earlier, and we can give you some good footwear advice and get you to put icepacks on your feet and you still have a great chance of getting rid of this nasty condition. If you want some more information, then you can visit our website, which is www.sydneyheelpain.com.au. Or call our staff at 93883322.
I hope you enjoy this educational video on plantar fasciitis and let you learn something today. Feel free to ask as many questions as you like and have faith that you don’t have to live with plantar fasciitis. Good luck!
Read more: Plantar Fasciitis Treatment
Written by Karl Lockett