What is my Heel pain and how can I treat it?
We put our feet through a lot every day; they facilitate standing, walking, running, jumping, dancing, and so much more. To do all these things, we rely on a network of bones, muscles, tissues, and nerves that all must work together in equilibrium. An imbalance in any of these structures can start a domino effect where the end product is dysfunction and PAIN.
According to the NICE clinical guidelines (the British clinicians' bible), PLANTAR FASCIITIS is the most common foot condition, accounting for 80% of all cases of heel pain. One in ten people will suffer from this condition at some point in their life. Is it any wonder we physios see so many of these cases hobbling into our clinics?
Plantar- meaning sole of the foot.
Fascia- the fibrous connective tissues that tethers the heel bone (calcaneus) to the base of your toes (heads of the metatarsal). It supports the bottom of the foot along the arch.
The meaning of 'itis' is inflammation. However, inflammation does not have a large part to play in the pathology; it is more degenerative (wear & tear) with microtears and impaired healing.
This condition can affect adults across the whole age spectrum, but most commonly those between 40-60. Here are some factors that increase the risk of you developing plantar fasciitis:
- Tight calf muscles (are you a poor post-workout stretcher?)
- Poor feet biomechanics (flat foot or high arches)
- Standing for prolonged periods
- Weight-bearing sports such as running
The main symptom of plantar fasciitis is long-term pain on the inside bottom of the Heel. Patients classically describe pain of a sharp nature which is worse standing first thing in the morning (a burning sensation as the foot is initially stretched on getting out of bed). After a short period of walking the pain usually reduces or disappears, only to return later in the day. Aggravating times are often after increased activity and rising from sitting. Patients often report that ice and anti-inflammatory medications help, but only temporarily.
If these are the sort of symptoms you are experiencing, then the MacTherapy® Heel Pain Treatment Kit will be just the treatment your heel is crying out for. But first, let's look at what successful treatments are out there and therefore, how we can help.
Effective conservative treatments:
Over 50% of people with plantar fasciitis can be successfully treated with conservative management. While this can take 6 to 12 months, there is more evidence for calf stretching as well as dedicated plantar fascia stretching and massage than any other treatment.
- Calf stretches- Performed by leaning forward into a wall with the affected leg extended behind and the Heel planted. Holding for 30 seconds and repeating 6 times.
- Plantar fascia stretching involves sitting on your knees and tucking your toes under- an unpleasant but very effective stretch. If the person cant get onto their knees, then they can stand facing a wall putting their toes up onto it and pressing inwards.
- Massage- nothing will beat getting an experienced professional working into the plantar fascia. Physios are especially trained to do this. Getting a massage as frequently as required may not be achievable for everyone, but using a spikey massage ball is a great alternative and can even be used multiple times a day. The focus of the massage is to break down the scar tissue, thickening and adhesions that have formed in the fascia and stimulate the blood flow to encourage better natural healing.
- Night Splints- These hold the foot and toes in a stretched position throughout the night. Regular use of these has been demonstrated to show great results in treating Plantar Fasciitis. They prevent shortening and tightening of the fascia while you sleep at night.
- Orthotic- or insert that is cushioned with an arch support. For this, we recommend you see an experienced Podiatrist. They will perform a thorough biomechanical assessment and prescribe you with the correct orthosis. These can range in price from £40 to £250 but fortunately, are generally guaranteed for life.
- Padding the Heel- This comes down to wearing appropriate cushioned footwear or a small insert. Doing so helps to absorb the force and shock of walking and running and prevents aggravating your symptoms.
- Relative rest- No one likes to hear it, especially athletes, but by reducing the amount of time you are on your feet will give the tissues a better chance to heal.
How does the MacTherapy Heel Pain Kit Help?
The MacTherapy Heel Kit has been designed around current research and based on the above treatment strategies.
Each pack contains:
- MacTherapy® Night Splint Sock-
Worn while sleeping or sitting, the Night Splint Sock gently stretches the plantar fascia, Achilles tendon, and calf muscle. This lengthens the tissue over an extended period to reduce shortening and promote healing.
- 2 x MacTherapy® Silicone Heel Socks- Protects the Heel and provides padded cushioned relief while weight-bearing. Cups the heel allowing the user to go about their daily business more comfortably, this is particularly important for people standing for long periods.
- MacTherapy® Peanut Massage Ball-
A versatile self-massage tool perfect for the feet. The uniquely designed 'peanut' shape allows a targeted and effective massage- particularly around the arch and heel of the foot. It improves blood flow to the plantar fascia working to break down scar tissue and promote healing.
What if I've tried everything?
If you have exhausted all conservative management and that involves following the above routine precisely, seeing a physiotherapist and being assessed by a podiatrist.
The final step would be to see an Orthopaedic Foot consultant or a Podiatric Surgeon. They can examine the foot under Ultrasound and prescribe a steroid injection if they feel it is appropriate.
Surgery as a (very!) last resort...
There are surgical treatments that can be used to treat plantar fasciitis. The surgery involves cleaning up the degenerative tissue, releasing any adjacent entrapped nerves, and releasing some of the tension in the calf muscles. This is a big surgery and would require the patient to stay for an extended period off their feet while everything heals. So the question many ask themselves is 'why didn't I rest and follow the advice when I was first told to?'
These surgical options should be reserved as a treatment of last resort after at least 1 year of active conservative treatments with stretching, splints and/or inserts.