Heel Pain
 Stand Firm - Don't Let Heel Pain Stop You
Plantar Fasciitis is a common overuse injury affecting the sole or flexor surface (plantar) of the foot.
A diagnosis of plantar fasciitis means you have inflamed the tough, fibrous band of tissue(fascia) connecting your heel bone to the base of your toes.
The classic sign of plantar fasciitis is heel pain (usually radiating down the inside of the sole of the foot) within the first few steps after getting out of bed in the morning.
After a few minutes, the pain may ease, as the foot warms up, then it may reoccur during the day, after extended periods on your feet.
You’re more likely to develop the condition if you are a woman, if you are overweight, or if you have a job that requires a lot of walking or standing on hard surfaces.
People with very flat feet or very high arches may also be more prone to plantar fasciitis. Your APA physiotherapist will evaluate the way you walk (gait analysis) to determine if there is a biomechanical cause of your condition. They may recommend insoles to support your inner arch and exercises to strengthen the muscles and/or stretch the muscles and fascia.
Your physiotherapist may reduce the pain and inflammation by using ice or heat, or electrotherapeutic modalities like interferential or ultrasound.
Stiff joints around the foot and ankle can be treated using mobilisation, where the physiotherapist gently moves the joints manually to remove the stiffness and restore the normal range of movement.
Stretching the plantar fascia is very important for encouraging the tissue to regain its normal alignment.
Studies have shown that stretching the fascia is more beneficial than just stretching the muscles.
Your APA physiotherapist can show you techniques and a range of equipment for stretching at home.
They may also show you how to tape your foot to support the plantar fascia and relieve some of the strain.
If you don’t treat plantar fasciitis, it may become a chronic condition, which is much more difficult to treat.
You may not be able to keep up your level of activity and you may also develop symptoms of foot, knee, hip and back problems because of the way plantar fasciitis changes the way you walk.
Preventing Pain
- Ensure that you wear appropriate, supportive, well-fitting footwear when exercising, walking, or standing up for long periods.
- If your weight is a contributing factor, consult a health professional for a healthy weight control plan.
- Physiotherapists can provide you with a sensible exercise program, tailored to your needs and taking into account your foot problems so that it is not aggravated.
- Stretching the achilles tendon and plantar fascia, as demonstrated by your physiotherapist, especially before and after exercise, may help to prevent the problem from returning.
Stay Strong
Avoid Ankle Sprains
The ankle joint has three bones that are precisely shaped to interlock and give stability. Strong bands of connective tissue called ligaments reinforce the joint and help hold the bones together. These ligaments prevent too much movement of the joint.
A sudden movement or twist, often when the foot rolls in, can overstretch the supporting ligaments, causing ligament tears and bleeding around the joint. This is known as an ankle sprain.
This is a common injury, particularly in activities that require running, jumping and change of direction (such as basketball and netball).
Symptoms of Ankle Sprain
- Swelling – the ankle can swell in minutes or over several hours.
- Bruising – over the area of injury.
- Pain – when trying to move the ankle joint and when walking, especially when the knee goes forward over the foot.
In more severe injuries there may be associated bone injury and it is wise to get an x-ray to determine whether there is a fracture.
First Aid for Ankle Sprains
Stop your activity and rest the injured joint. Use icepacks every two hours, applied for 15-20 minutes. Bandage the joint firmly, and extend the wrapping up the calf and down the foot. Raise the ankle above heart height whenever possible, preferably lying down.
Avoid exercise, heat, alcohol and massage in the first 48 hours after injury, as these can all exacerbate swelling. See your APA physiotherapist if your ankle injury does not settle in a day or two.
Recurring Ankle Sprains
Some people suffer from recurring ankle sprains. This can be caused by a number of factors working in combination, including:
- Ligament Scarring – and excessive looseness, as a result of previous ankle sprains;
- Insufficient Rehabilitation – leading to weak muscles around the ankle joint;
- Proprioceptive Deficit – decreased capacity to judge where your foot is in relation to your leg – this can be resolved with appropriate physiotherapy.
Rehabilitation & Support
If the pain from a sprained ankle that you are managing yourself has not improved after a day or so, it is best to seek the advice of your physiotherapist.
Ankle sprains need thorough investigation and rehabilitation. As experts in functional movement, physiotherapists are ideally placed to assess and treat these common injuries.
Physiotherapy treatments may include:
- Exercises to strengthen all muscles surrounding & related to the ankle;
- Advice on taping and ankle braces for use during activity, if required;
- The use of a wobble board or trampoline, and other exercises, to encourage balance and improve the proprioceptive deficit;
- Exercise programs to improve mobility of the joint, as necessary.
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