Physio for heel pain - plantar fasica - what works?

Do you have a pain under the heel of your foot?

You have come to the right place.

You find pain particularly under the heel when getting up after resting or getting up in the morning.

We usually guage improvement by how many steps you can take until pain eases.

A trend we commonly find is that patients often walk barefoot on hard floors.

A study was published recently to help us guide management of this annoying problem.

If you make an appointment we will be glad to help your fastrack to recovery.

There is strong evidence in the research that for the first four weeks after pain onset:

  1. Stretch the plantar fasica

  2. Apply supportive taping

  3. Education in 4 areas:

  • manage load - static and dynamic

  • pain education - clarity, prognosis and monitoring

  • related conditions eg BMI and other long term conditions

  • footwear - RF/FF drop, soft and support, comfort, socially acceptable.

Week 4-12

You may have seen this advertised around the place…but how can using a machine help my heel?

Well, there is Moderate evidence for Extracorporeal Shockwave Therapy (ESWT) when you haven’t seen any response to the above core approach. I.e. You have done well all of the above. From other reading the ESWT tends to work best where there is calcific changes in the tendon…but not always!

  • Pros: stimulates healing of the tendon

  • Cons: can be uncomfortable, requires 6x physio sessions

At 3 months:

If you haven’t already, then see the podiatrists to experiment with orthotics and foot review.

  • Pros: shoes and inserts help to support the arch and manage load. They are particularly indicated where taping has been useful and helps you get around easier.

  • Cons: Orthotics don’t come cheap, however if you’ve been suffering for a while and have tried the above, then definitely get an assessment.

At 4 months

So you’ve come to the end of your rope, and tried all of the above with the associated ups and downs and still no joy with recovering your heel pain back to full recovery, then in consultation with your GP or podiatrist you may also consider injections.

Solution

These feet pains can be super annoying, so why wait any longer.

Book in and start your recovery today.

Tim Jenkins

APA Sports Physiotherapist

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ref:

Management of plantar heel pain: a best practice guide informed by a systematic review, expert clinical reasoning and patient values accessed https://bjsm.bmj.com/content/early/2021/05/09/bjsports-2019-101970