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Category: heel pain
Plantar Fasciitis REVIEWED
Feet play an important role in posture and gait. Foot pathologies are common amongst the adult population, in particular plantar heel pain. Foot pathologies contribute to a negative impact on quality of life. Plantar heel pain (or Plantar Fasciitis) is a common musculoskeletal foot injury and the most common condition presenting to our Townsville Podiatry clinic. Below is a summary of a recent review of the research on plantar heel pain. Learn more about Plantar Fasciitis or Heel Pain here. Review of research on Plantar Fasciitis or Heel Pain Plantar heel pain is most common between 40 and 60 years and may affect both athletic and non-athletic populations, but the incidence is higher among runners (affecting 17.4% of running population). The pathology is characterized by pain in the medial (inside) heel that is exacerbated by weight-bearing activity, as well as after periods of rest. Plantar Heel Pain is often chronic with typical symptoms lasting more than a year. Despite the name “Plantar Fasciitis” – the condition is considered a degenerative pathology rather than a primary inflammatory condition. Therefore, the more correct terms which should be used from now on are fasciosis or fasiopathy or plantar heel pain. Authors found that while Body Mass Index (BMI) was not associated with plantar fasciitis in the athletic population, there was evidence to support such an association in the non-athletic population. Muscle function and muscle size differences between those with and without plantar fasciitis was reviewed in seven studies - and the strength of muscle groups including hallux plantar flexion, lesser toe plantar flexion, ankle dorsiflexion, ankle inversion, and ankle eversion was lower in patients with plantar fasciitis. Studies found that patients with plantar fasciitis were more likely to have increased plantar fascia thickness, hypoechogenicity, and plantar calcaneal spurs. Patients with plantar fasciitis had 2.16 mm thicker plantar fascia than controls and tended to have absolute plantar fascia thickness values exceeding 4.0 mm. Review of Treatments for Plantar Heel Pain Corticosteroid Injections: Corticosteroid injections have been used for the treatment of plantar fasciitis as it can reduce inflammation, fibroblast proliferation and ground substance proteins, which have been thought to play roles in pathogenesis of plantar fasciitis. The review of the literature concluded that compared to placebo, corticosteroid injection was more effective in relieving pain at one month but not over longer intervals. Among 21 trials that reported adverse events, two ruptures of plantar fascia, three injection site infections, and 27 minor adverse events such as post-injection pain were reported. ESWT Extra-Corpeal Shockwave Therapy: The proposed mechanisms for the effect of ESWT include increasing nerve supply, blood supply and collagen synthesis in degenerative tissues. Shockwave reportedly have benefits in pain reduction at 12 weeks, unlike corticosteroid injections. ESWT showed greater reduction in VAS pain scores and success rate of improving heel pain by 60% over placebo when taking first steps and during daily activities. The most recent of studies compared ESWT with other therapies and found greater success rate, greater reduction in VAS pain scores, decreased return to work time, greater overall reduction in plantar fascia thickness up to 6 months post-treatment and less complications in those treated with ESWT compared to other interventions. The 39 studies concluded that while there may be common side effects such as pain during treatment and transient erythema (redness), complications during the first year of follow-up are highly unlikely and concluded that Shockwave Therapy is safe for treating plantar fasciitis. Low-Level Laser Therapy (LLLT): LLLT is a form of photobiomodulation therapy that involves the use of wavelengths ranging from 620 nm to the infrared (820–904 nm) over the surface of patient’s skin. The proposed mechanisms include anti-inflammatory effect as well as stimulation of cell proliferation, microcirculation, vascular neoformation, and collagen production . Fewer studies have been conducted on the efficacy of LLLT in the treatment of Plantar Fasciitis, however the systematic reviews that have been done found that LLLT significantly improved pain and function and decreased plantar fascia thickness compared to other therapies, such as exercise. In Summary Regarding treatment efficacy for management of plantar fasciitis, outcomes using corticosteroid, PRP, and ESWT may have the largest number of studies and most reviews concluded longer-term outcomes favoured non-corticosteroid interventions. Similar to tendinopathy, plantar fasciitis has been characterized by degeneration of collagen even though inflammation may play an important role in the early disease process. However, this does not mean that inflammation and degeneration represent a continuum of disease but reflect two distinct or often coexisting processes. Therefore, corticosteroids may offer benefits in short term particularly within 1 month following treatment. By Hayley Paterson | Biomechanical Podiatrist A Systematic Review of Systematic Reviews on the Epidemiology, Evaluation, and Treatment of Plantar FasciitisHye Chang Rhim 1,† , Jangwon Kwon 2,†, Jewel Park 3, Joanne Borg-Stein 4,5 and Adam S. Tenforde 4,5,*Read More
Townsville Heel Pain Clinic
Welcome to Townsville’s Heel Pain clinic where we pride ourselves on the non-surgical, effective treatment of your heel pain. Heel Pain is the # 1 condition we treat on a daily basis at Foundation Podiatry - in fact over the last 15 years here in Townsville we have helped 8000+ happy campers resolve their heel pain and get back to enjoying their active lifestyle! [feature-block] Do you wake up in the morning limping from a painful heel? Feeling frustrated as you can’t exercise or chase the grandkids around? Have you tried other treatments and nothing seems to be working? Want to avoid a big needle… or even worse… surgery? [/feature-block]Read More
Why am I suffering from heel pain?
When heel pain and discomfort becomes an issue, it can be a major disruption to your day-to-day routine, especially if you lead a busy, active life. Let’s face it; we need our feet and legs for the most basic daily tasks, whether it’s driving, exercising or simply walking. When you’re suffering from heel pain, all these basic tasks can become much more challenging, and that can have negative consequences on your quality of life. Foundation Podiatry is Townsville’s Heel Pain clinic where we pride ourselves on the non-surgical, effective treatment of your heel pain. Contact us for more information. What is Heel pain? Heel pain is one of the most common complaints we receive from our patients. As Podiatrists we see this problem every day ranging from children to adults. Overuse or injury to the heel may trigger heel pain. This can range anywhere from mild to disabling. The overwhelming majority of heel pain in adults can be attributed to one condition, Plantar Fasciitis. The pain commonly occurs at the bottom of the foot called the plantar surface and may extend into the arch of the foot. What causes Heel pain? Often there has been an increase in load placed on your lower limb that your body has not had the capacity to deal with resulting in injury. This increase in load may include: Jobs that require lots of walking on hard surfaces Prolonged barefoot on hard surfaces Starting a new exercise program; or increasing your training intensity/volume or style Weight gain Wearing old, worn out footwear; high heels Certain foot types may increase your likelihood of developing heel pain – such as tight calf muscles, weak intrinsic foot muscles, high arch rigid feet with poor shock absorption etc. Certain factors may increase the risk of developing heel pain and/or impair your body’s own ability to repair the injury – such as Diabetes, Rheumatoid Arthritis, menopause, obesity, old age, stress, inadequate sleep. Heel pain can occur from a one-time incident/injury however it is much more likely due to an overuse injury. Do you suffer from heel pain? Contact us today to get a treatment plan in order. What are the symptoms of Plantar Fasciitis? Heel pain usually affects just one foot, but it can affect both feet. Common symptoms may include: Pain under the heel which may extend into the arch Heel pain is usually worse the first few steps in the morning and after rest periods during the day Heel pain often aggravated by prolonged standing, walking or running, especially on hard surfaces As the condition progresses, patients may experience burning, numbness and throbbing around the heel when resting at night What is the best treatment for heel pain? Heel pain is a common condition yet complex in nature, where a ‘one size fits all’ treatment approach often fails. How we manage heel pain for one person may be quite different to the next person. We take into consideration factors such has occupation, age, body weight, how long have you had heel pain for, how capable is your body of healing itself? After a detailed Initial Biomechanical Assessment at Foundation Podiatry Townsville, we will be able to recommend to most appropriate treatment for your heel pain. We utilise the latest treatment options with a personalised approach to make you pain free in the shortest possible time! Treatment options for heel pain may include: Medical Laser Therapy Shockwave Therapy Mobility, Balance & Strength exercises Medical Acupuncture Custom Foot Orthoses What can I do to reduce the likelihood of developing heel pain in the first place? Wear suitable footwear (avoid high heels and pointy toes) Reduce barefoot time on hard surfaces (but don’t avoid barefoot altogether) Stretch calf muscles regularly Roll/ massage plantar surface of foot regularly Slowly increase intensity/ frequency of exercise Maintain a healthy body weight How Can Foundation Podiatry Help You? At Foundation Podiatry, we pride ourselves on being a locally owned and operated business. Our Podiatrists, Hayley, Chris and Emma have over 45 years’ combined experience working with heel pain and other complex foot, ankle and lower limb conditions. We treat people as individuals and offer specific treatment options for specific needs. If you’re suffering from heel pain, get in touch with us to see how our varied treatment options and personalised approach can help you.Read More
Running Related Injuries
Image A is an injured runner displaying contralateral pelvic drop – that is, the hip/pelvis on the non-weight bearing limb drops lower than the weight bearing limb during the stance phase which results in an inward position of the knee and subsequent increase in foot pronation (rolling inwards). This position has been linked to developing pain at the front (patellofemoral pain) and at the side (ITB friction syndrome) of the knee, shin splints and achilles tendon pain. Image B is a healthy runner who is not displaying contralateral pelvic drop.Read More
Medical Laser therapy explained
Medical Laser Therapy is the application of red and near infrared light over an injured site to promote tissue healing. Hayley shares in her video: How it works Conditions we use Medical Laser on in our clinic Why we love it!Read More
Hayley shares the down-low on Shockwave Therapy
Extracorpeal Shockwave Therapy (ESWT) is a treatment modality used to treat chronic musculoskeletal pain. Shockwave Therapy sends sound waves into the injured tissue to accelerate healing. Persistent Plantar Fasciitis (heel pain) and chronic achilles tendon pain are the most well-researched and the most commonly treated conditions with shockwave therapy. Hayley shares in her video:> Conditions we use Shockwave therapy for in our clinic> How it works > Why it's the bomb for chronic injuries!Read More
Medical Laser therapy in the management of Plantar Fasciitis
Plantar Fasciitis (now more correctly termed plantar fasciopathy or plantar heel pain) is a common cause of heel pain in adults. With plantar heel pain the plantar fascia becomes weakened and degenerative causing pain where it inserts into the heel bone. This pain often occurs due to an increase in load on the feet, increase &/or change in training style/volume, over-pronated foot type and restricted ankle joint or tight posterior chain. Learn more about Plantar Fasciitis hereRead More
I have heel pain - I must have a heel spur!
A very common question I get asked in my Townsville Podiatry clinic: "I have heel pain, so I must have a heel spur!" Having heel pain does not necessarily mean you have a heel spur. Conversely, having a heel spur does not necessarily mean you will have heel pain. One study showed that 45% of the heels analysed were either painful with no plantar heel spur or had a plantar heel spur but were not painful. Another study showed plantar heel spurs in 10-63% of asymptomatic controls. The most common cause of heel pain in adults is Plantar Fasciitis (now more correctly termed plantar heel pain) however there are many other causes of heel pain.Read More
We Provide Personalised Treatment Options for Foot Pain in Townsville
Foundation Podiatry is a locally owned and operated clinic which has been managing foot, ankle and leg pain for the people of Townsville for 13 years now. Our Townsville Podiatrists - Hayley Paterson and Chris Weber - both have 15 + years of experience working in the field of Biomechanical Podiatry and dealing with foot and lower limb pain. We pride ourselves on offering a unique, personalised approach to treatment. We understand that every person and every presenting condition needs to be treated differently to achieve the best outcomes, and we take the time to do this. When you’re suffering from ongoing foot pain, ankle pain and/or leg pain it can have an impact on every aspect of your life. Daily tasks become more difficult, exercise often goes out the window and your patience, mood and general well-being are affected. I hear all too often in my Townsville Podiatry clinic “I didn’t realise how important my feet were until they started causing me pain and impacting my life.” Below is an example of the common foot and lower limb conditions we treat on a daily basis at Foundation Podiatry Townsville: Heel Pain (Plantar Fasciopathy) Achilles tendinopathy Bunions Myriad of forefoot pain Posterior tibialis tendon dysfunction (adult flat foot) Ankle pain, instability Shin pain Leg pain/ knee pain Women’s Foot Health Chronic pain & Arthritis Click here for more detailed information on these conditions. If you find yourself suffering from foot pain in the Townsville area and are sick and tired off it impacting every aspect of your life, get in touch with our locally owned & operated clinic today, we would love to help you out!Read More
Are Heel Pain and Menopause related?
In our Townsville Podiatry clinic we see many more middle aged women with heel pain than younger women - are hormones at play? Sometimes, pain creeps up on you – it can be difficult to pinpoint the exact moment it started. But suddenly you’re sore all the time. Menopause can be the same! There is no clear start or ending point of menopause; but when it does begin there is a rapid drop in oestrogen in the first six months then it continues to steadily decline over the next 3 years. Menopause usually starts around the ages of 45 - 55 years. So what are the symptoms of Menopause? When you think of someone heading into menopause usually you imagine hot flushes, sleep disturbances, mood changes, weight gain, changes to the menstrual cycle etc... all of these changes can be attributed to the lowering oestrogen levels. But reduced oestrogen, combined with ageing, can also impact the health and happiness of our skeletal tissues. Lower oestrogen affects our collagen production. Collagen is basically the building block of our musculoskeletal system - bones, muscles, ligaments, tendons and skin. Less collagen synthesis means less elasticity of tendons and skin, constriction of blood vessels, decreased healing, increased risk of developing a soft tissue injury and joint pain. Oh the joy! Age related loss of muscle size and strength (also known as sacropaenia) in addition to low oestrogen related weight gain can leave middle aged women in a precarious position. It can also change the way women walk, move and hold themselves. The thing is, pre-menopause women have a lower risk of soft tissue injury than men do but once menopause kicks in and oestrogen levels drop - soft tissue injury risk increases. That’s why we see way more middle aged women with heel pain than younger women. But not only heel pain - Achilles tendon pain, ankle pain, knee/hip/back postural pain can all increase during menopause – especially if there are changes in the way women walk . So is heel pain related to menopause? The answer is – it can be.Read More
What causes Heel Pain (Plantar Fasciitis)???
Plantar fasciitis is the most common cause of heel pain. Heel pain is most common in the 40 – 60 year age group. It is so prevalent that ~80% of adults will suffer a bout of heel pain over the course of their adult life-time. The plantar fascia is a strong structure in the arch of the foot, kind of like a bow-string. When the plantar fascia becomes injured, pain is felt in the front of the heel and sometimes in the arch of the foot. It is much worse first thing in the morning and after rest periods, causing you to hobble like old Mother Hubbard. Unfortunately this hobbling can then cause pain and tightness in other parts of your body! So what actually CAUSES heel pain?? To put it simply, plantar fasciitis occurs when the continual daily mechanical load on the plantar fascia (main supporting structure of the arch) is greater then what the body can continue to repair. Every time you rest or sleep, your body goes into repair mode to heal any little niggly stuff that has happened throughout the day. In an optimally functioning body, tissue load would equal tissue repair. When plantar fasciitis occurs it is because tissue load is much greater than tissue repair. This excessive load causes a weakening and degeneration of the plantar fascia, and in some cases tears may be present. The condition is now more correctly termed plantar fasciosis (degeneration) instead of plantar fasciitis (inflammation). The following factors may contribute to increase mechanical load of the plantar fascia: Occupations which require lots of walking or standing on hard surfaces. Foot Posture – having collapsed arches or high arch, rigid feet cause increase load on the plantar fascia. Over-training or sudden increase in training. Being over-weight – even with good foot posture those extra kg’s dramatically increase the load on the plantar fascia. Certain types of training that place a lot of stress on the feet – long distance running, sprinting, ballet, basketball etc - may contribute to an earlier onset of plantar heel pain. Certain medical conditions may predispose people to developing heel pain such as diabetes and rheumatoid arthritis. Quite often however, the finger pointing can’t just go towards the over-training, the long hours or the hard surfaces at work. More often than not, our feet are just not capable of doing their job! They’ve become stiff, rigid and weak and therefore no longer act as efficient springs for our bodies. This is largely due to our modern footwear. Shoving your feet into pointy toe shoes all day switches off your intrinsic foot muscles which makes your feet lazy. As your big toe gets pushed towards your second toe – it can no longer support your arch. Having a heel raise in your shoe tightens up your calf muscles which in turn strains your arch more. Our toes are supposed to be able to spread, our heels should be on the ground. Over time our feet have become stiff, weakened, crappy structures – allowing heel pain to occur. To address the real cause of heel pain we need to wake these feet up again – unlock their true potential! At Foundation Podiatry we have designed the ACTIVE FOOT FORMULA to do just this. For more detailed information on heel pain click here. Don't walk like old Mother Hubbard any longer! Talk to us today!Read More
Effective Treatment for Heel Pain in Townsville
Yes, heel pain in Townsville is common. Your work colleague, your sister - they've probably had it too. But so what!!! Heel pain can be darn PAINFUL! It makes you hobble like an 80 year old and can stop you from exercising. The thought of standing all day at work with heel pain is cringe worthy. Heel pain can even cause you to get tired and grumpy by the end of the day (& let’s face it - nobody wants to hang out with that person with the monkey on their back!) So why put up with heel pain?? Yes heel pain is common - in fact a large number of people will suffer a bout of heel pain across their adult life time. But this does not mean that it is not important and does not need to be treated. "As a Podiatrist in Townsville, I get tired of GP’s telling patients to put up with their heel pain – it will eventually go away". Why put up with pain for 3 months, sometimes 9 months, or in some cases for many years – when heel pain can be treated successfully, allowing you to enjoy a busy, active lifestyle? As previously mentioned, heel pain is a very common condition - yet it can be quite COMPLEX in nature - where a 'one size fits all treatment approach' often fails. An accurate diagnosis is important to recommend the most suitable treatment plan. Treatment for heel pain is often quite simple - especially if you seek treatment promptly. Often strapping to decrease the strain/load on the arch of the foot can give an immediate 40-70% reduction in pain!! Gentle exercises to warm the foot up after rest periods are very important. Certain shoes may help or exacerbate your heel pain. In some cases of heel pain, simple stretching and strengthening exercises is all that is required to be pain-free again. Some people may need Foot Supports (Orthotics) to completely knock their heel pain on the head. While others may require Low Level Laser therapy, Medical acupuncture or Shockwave therapy to kick-start their body's healing process. So as you can gather, how one person responds to heel pain treatment may be very different to the next person. At Foundation Podiatry we help ease the symptoms of heel pain for Townsville-based sufferers on a daily basis. In fact, our Podiatrists only deal with foot and lower limb pain - every patient, every day. We respect that all our patients are different. We utilise the latest treatment options with a personalised approach to help you become pain-free in the shortest time possible! For a more detailed explanation of heel pain click here. So please, don’t just put up with dreaded heel pain any longer – come and have a chat with our friendly Townsville Podiatrists today!Read More
Hints & Tips
From injury prevention, demystifying modern footwear, running techniques & tips, how to improve mobility & restore function, to even help you overcome the Donald duck walk and get you engaging your core through barefoot activation! All that wisdom and more is shared on our Hints & Tips page! Be sure to drop back to our Hints & Tips page as it will be updated on a regular basis. The feet are a very complex part of the body, allowing you to perform essential daily activities as well as tackle inspiring physical achievements - so they should not be neglected! Our foot experts, Hayley, Chris and Emma will work with you to address your goals, relieve pain, regain mobility and effectively treat your foot problems. Do you have sore toes, bunions, or get heel pain when running? Are you wanting to learn more about footwear? Concerned about whether barefoot is good or bad? Interested in injury prevention and improving your performance? Reach out to our Townsville Podiatry team today! Contact UsRead More
Persistent HEEL PAIN? Shockwave therapy may be your answer!
Intense Heel Pain getting out of bed in the morning? Is it just NOT going away? Is your heel pain stopping you from exercising & making you grumpy? Ever heard of Shockwave Therapy??? Heel pain is a common condition yet it can be quite complex in nature, where a ‘one size fits all’ treatment approach often fails. How one person responds to heel pain treatment may be quite different to the next person. Therefore it is very important to have it correctly diagnosed and then treated to your individual presentation. The most common cause of heel pain is plantar fasciitis. The plantar fascia is a thick fibrous band that supports the arch of the foot. In some people this thick band becomes weakened and degenerative and therefore painful. Heel pain is usually worse first thing out of bed in the morning and after rest periods. READ HERE for a more detailed explanation of heel pain. Myth Buster: I have heel pain – I must have a heel spur!! NOT generally the case: FIND OUT MORE Okay, so heel pain is… a pain in the heel! But it’s not just the pain that you have to put up with – it’s the domino effect of the pain. > The thought of putting your joggers on and going for a walk – no way! > Standing all day at work on concrete – the thought makes you cringe. > Cooking dinner when you get home – let’s just get takeout. > Your son is pining for your attention and wants to play in the back yard – you have no energy left as your heel pain has zapped it all. So why put up with HEEL PAIN when it presents all these other detrimental effects? Heel pain in adults is common, complex – yet VERY TREATABLE! At Foundation Podiatry Townsville we utilise the latest treatment options with a personalised approach to make you pain free in the shortest possible time. Treatments often include strapping, stretching, medical acupuncture, strengthening exercises, improving footwear, cushioned foot supports etc. In some cases of resistant heel pain, further treatment is necessary such as: long periods of immobilisation (really, who can do that?), cortisone injection or surgery (OUCH!!!). UNTIL RECENTLY – Shockwave therapy is now recommended prior to considering the above nasties. Shockwave therapy delivers acoustic (sound) waves to the injured tissue to help your body heal your injury. It is non-invasive, relatively pain-free and you can return to work straight after your treatment. We are getting wonderful results at Foundation Podiatry Townsville, helping many people return to an active lifestyle. For more detailed information on Shockwave Therapy READ HERE. Shockwave therapy is also commonly used for chronic achilles tendon pain. DON’T LET HEEL PAIN ZAP YOUR ENERGY – Give Foundation Podiatry Townsville a call today on 4775 1760!Read More
Heel Pain in Children: Why do my child’s heels hurt when playing sport?
Heel pain is not only limited to grown-ups. Heel pain in children is common. Often, healthy active children will complain of pain in one or both heels during and after running and playing sport. The pain is located at the back of the heel, however children may complain of ‘sore ankles’. The most common cause of heel pain in children is a condition called Calcaneal Apophysitis (previously called Sever’s Disease). Calcaneal Apophysitis is due to overuse and repetitive micro-trauma of the growth plate within the calcaneus (heel bone). It occurs between the ages 8 to 14 and is more common in boys than girls. Treatment for children's heel pain can include reducing activity (but not completely stopping), strengthening, ice after activity, massage, avoiding barefoot and strapping to support the arch and reduce the load on the achilles tendon. Sometimes cushioned heel raises or foot orthotics are required. Calcaneal Apophysitis is self-recovering – meaning it will go away completely when the two parts of bony growth join together. There are no known long term complications associated with children's heel pain. Heel pain in children can be very painful, causing them to limp on the sporting field and not be as agile or fast as their team mates. Treatment however is simple and effective – so don’t make your child sit out the sporting season when they can manage their pain and continue to play. You can read a more detailed explanation of Children's Heel Pain. Heel pain however is only one lower limb complaint that can slow your child down - have a read of our Children's Foot Health Section to learn more. [feature-block] Allow our friendly Podiatrist’s at Foundation Podiatry Townsville to keep your child on the sporting field and kicking goals! Book Now [/feature-block]Read More