Let’s talk about those ‘knackered knees’
26th February 2018
Persistent or chronic pain ? There must be something still injured right? Maybe not!
8th March 2018
Plantar fasciitis
Have you got pain in your foot? You could have plantar fasciitis! OR 'plantar fascia pain' or 'plantar fasciopathy'. Find out what all those things actually mean? And why just stretching is not going to help your plantar fascia pain go away?
What is the plantar fascia?
The plantar fascia is a soft tissue structure most similar to tendons. It runs from the under part of your heel bone (calcaneum) and then fans out to attach to the base of each of your toes. It comes under load when you are on your feet and it helps you to walk normally. Unfortunately it can sometimes cause pain and there are various terms to describe the different states of the tissue.
Plantar fasciitis
This, in it’s truest sense, is an acute (less than 6 weeks) inflammatory reaction of the tissue in response to being suddenly overloaded - lots of walking, jumping, running, being on your feet beyond what you’d normally do.
If this is what you have got, back off from being on your feet as much, rest up for a couple of days or weeks, and then as your pain settles gradually get going again. Job done!
Now most people unfortunately don’t have this presentation. They just describe a gradual onset of symptoms over time. This is typically not inflammatory therefore not an ‘itis’ (meaning ‘inflammation of’).
Plantar fasciopathy
It sounds terrible but plantar fasciopathy is a term to describe the tissue when it is in a degenerative state. It is similar in it’s features to how long standing tendon problems present, where changes in the tissue called collagen (the stuff it’s made up of) can happen where it breaks down, can calcify and nerve or blood supply can grow in.
Degenerative, categorically DOES NOT mean it will snap or that all hope is lost! It just means that the tissue is NOT in great shape. But the wonderful thing about our bodies is we can change and adapt!
Can plantar fasciitis be cured?
It normal to think "does plantar fascitis go away?" and "how long does plantar fascitis last?" The answer is, Yes 100% it can go away. It takes time and perseverance but if you are sick and tired of it making you miserable we're sure you are up for it!
There are 2 phases to plantar fasciopathy:
Pain dominant phase
Painful and stiff first thing in the morning, painful on start up from sitting, walking longer distances or standing too long. The aim in this phase is to reduce the load, so get off your feet in a similar way to a true plantar faci ‘itis’.
Load dominant phase
Basically overall it’s better (less painful) unless you overdo it. So what now? Simple, load it. Gradually and progressively get the tissue stronger to make it more resilient and tough.
Stretching won't cure it!
Some people may benefit from losing weight if it's indicated, often you may be tight in your calves, but plantar fasciitis stretches alone WILL NOT resolve the problem.
Sometimes people are stiff into toe extension although the jury is out in terms of the research on this one. Ultimately if it’s tight stretch it, it will do no harm.
Do I need an injection or surgery?
We get asked a lot about Plantar fasciitis injections and Plantar fasciitis surgery. We stand strong on this one......DON'T DO IT! It does not need it! The tissues need to get stronger, not be operated on or injected. The injection also carries a high chance of causing the plantar fascia to rupture! You definitely DO NOT want that!!!
Bits & Bobs
Researchers have found some association with reduced toe flexor and evertor muscle strength, and tight hamstrings. Again it will cause you no harm to get stronger in your foot and looser & stronger in your hamstrings. Often footwear with a hard insole can make things painful so if it helps, use a soft insole or wear cushioned trainers.
Plantar Fasciitis In Runners
Runners are a group that often get this problem. It can be due to an increased pace, increased mileage or alteration in your footwear or strike pattern. Initially follow the general advice above but for more specific rehab book an appointment.
If you think you might have plantar fasciitis and are not sure what your contributing factors are and how to get the plantar fascia stronger, please get in touch.
Book online using any of the links on this page or call us on 01625 422825 and start your road to recovery!
You CAN get rid of all this pain in a fairly short space of time, you just need some GREAT rehab specific to you.
We treat the person with the problem not just the problematic body part. We want to help you enjoy your life, pain free!
I came to Hogan & Mitchell as a runner with a problem of worsening 'plantar fasciitis' and I could sense that my experience was going to be different - a lot of time was spent explaining the problem and what I needed to change to improve the situation. As a runner the last thing I wanted was to stop running and they helped me to continue training whilst undertaking a program of rehab. No 'quick fix' was promised but the results are there - I now understand more about the issue and feel empowered to resolve it myself. This was definitely a different experience but one I strongly recommend.
Neil G.
I highly recommend Hogan & Mitchell - I went to see them with a foot injury, which was giving me on-going pain in my heal following completion of the London Marathon earlier this year. They carefully assessed me, listened to the issues and methodically reviewed me from top to toe. They pinpointed the problems and, over a series of sessions, put me through a series of exercises to support the required improvements. I am delighted with the outcome and am well on the way to a full recovery and back to running, although I will probably stick with half-marathons from now on!
Robert G.
