​Plantar Fasciitis (Arch or heel pain)

Plantar fasciitis is one of the most commonly presented and treated foot complaints within Greg's podiatry practice.

Plantar fasciitis is commonly used to refer to heel and arch pain.
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The plantar fascia is a long, thin ligament (non-elastic fibrous band of connective tissue) along the bottom of the foot extending from the heel bone, splitting and fanning out to attach to the toes.
Plantar fasciitis is a condition where the plantar fascia becomes inflamed (more specifically “microscopic tearing” to the structure) from overstretching or overuse, resulting in pain in the heel and/ or arch area of the foot.
Causes
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Plantar fasciitis occurs when you strain or irritate the plantar fascia ligament. Repeated strain can result in tiny tears in the ligament, leading to pain and swelling, which can make walking difficult.
Strains can occur due to:
  • Over-pronation – which is the foot rolls inward excessively when walking, it flattens the foot, lengthens the arch and puts added tension on the plantar fascia.
  • High or low foot arch
  • Obesity or sudden weight gain
  • Tight Achilles tendon (connects the calf muscles to the heel)
  • Starting a new activity or increasing the intensity of an activity
  • Wearing improper shoes with soles that are too soft, do not fit well or offer poor arch support.

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Symptoms
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The major complaint of plantar fasciitis is pain and stiffness in the heel and foot. The pain associated with this condition becomes more intense:
  • - In the morning when you step out of bed and first steps are taken
  • - Walking after sitting or standing
  • - Climbing stairs
  • - After exercise
  • - With high impact weight-bearing activities.
Treatment

Greg will conduct a physical examination of your lower limbs and feet as well as carry out a thorough biomechanical examination. This will include a static and dynamic video and pressure plate mat gait analysis of how you stand and walk/ run.
 
Greg will discuss a custom treatment plan with you.
Treatment often consists of combination therapy, most importantly is supporting the arch with custom
functional orthotics to keep the plantar fascia and other structures from overstretching.​
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In brief, treatment may consist of the following:
  • Rest
  • Ice
  • NSAIDs (non-steroidal anti-inflammatory drugs)
  • Muscle, tendon strengthening and stretching/ mobility program.
  • Orthotics or supportive shoes may be recommended to reduce the pain while walking or standing
  • Shockwave therapy (ESWT)
 
Further treatment options:
  • A steroid injection may be administered into the plantar fascia for reducing pain and inflammation
  • Night splints can be suggested to help stretch the plantar fascia while sleeping
  • Extracorporeal shockwave therapy (ESWT), which uses high-energy shockwave impulses to stimulate healing of the damaged plantar fascia tissues
  • Surgical referral - considered only if conservative therapy does not provide effective relief.
Custom orthotics
Extracorporeal shockwave therapy (ESWT) treatment

​1 Stan Road, Grayston Drive, Morningside, Sandton. Johannesburg 2057