Plantar Fasciitis (sometimes called "Policemans heel") is inflammation of your plantar fascia which is the ligament that stretches from your heel bone to the base of your toes. It supports the arches of your foot and also acts as a shock absorber. The causes of this painful condition include combinations of the following:
• Standing for long periods of time
• Excessive pronation or 'flat feet' which also causes knee, hip & back problems due to your feet collapsing inwards when you walk. This also causes the Achilles' tendon behind your heel to stretch and curve inwards.
• Wearing shoes with poor cushioning or arch support
• Increasing weight bearing exercise too rapidly or with too much enthusiasm
• Poor spinal posture that concentrates your body weight unevenly to your feet
Severe pain in your heel is the main symptom of plantar fasciitis. This can be anywhere on the underside of your heel and will be very tender to touch. The pain is worst when you take your first steps in the morning, and after long periods of rest. Equally however, walking or standing for too long will aggravate the condition and resting will ease it.
Conservative treatment for plantar fasciitis is long term. Resting is necessary so you do not continue to re-injure the fascia. You must avoid running, excessive walking and standing for long periods of time. Do not walk barefoot on hard surfaces. Choose shoes with cushioned heels and a good arch support. Support for your foot is paramount. Avoid old and worn shoes. You may need to utilize multi physical therapies including chiropractic, podiatry, remedial massage, acupuncture, as well as regular home care including ice-ing, stretches, gentle specific exercises, rolling your foot on a rubber ball or over a frozen bottle of ice.
If conservative treatments are not helping, other treatments are available for difficult, severe or persistent cases. These include steroid injection, botulinum injection, radiotherapy, extracorporeal shock wave therapy, wearing a night-time splint to prevent the fascia from tightening and lastly, surgery.
The prognosis for plantar fasciitis is generally good. Most people recover completely from an episode within a year. However some of the treatments mentioned here may speed up recovery. Prevention is always better than cure and would include but not be limited to:
• Wearing supportive shoes with adequate arch supports and cushioning for the heel.
• Avoid wearing worn shoes, thongs and non supportive sandals
• Regular stretching of the plantar fascia and Achilles' tendon, especially before exercise.
• Avoid exercising on hard surfaces.
Get your spine adjusted regularly to maintain correct postural balance.
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