A NUMBER OF THESE RISK FACTORS ARE UNDER OUR CONTROL
• Abnormal foot biomechanics (e.g. having a high arch, incorrect pattern of walking and others)
• Certain occupations which requires the person to spend a lot of time on the feet
Relationships have also been proposed, but not established, for other factors, such as acute injury, the presence of a heel spur, the shoe type, the walking surface and others.
From this list it is evident that the risk of developing plantar fasciitis can be significantly reduced if we do the following:
• Maintaining a healthy weight
• Making sure that if we are involved in sports which stress the plantar fascia, we have the correct technique
• Trying to limit the time on our feet. Even if our occupation forces us to be on our feet a lot it is usually still possible to take breaks and do certain stretches which take the pressure off the plantar fascia, allowing it to recover.
There are a number of treatment options available for plantar fasciitis and there is a consensus that nonsurgical treatment is effective approximately 90% of the time, which is very reassuring. The most treatment approaches are physiotherapy, night splints and orthotics. Physiotherapy treatment includes ultrasound treatment and drug phoresis, soft tissue massage and stretching of the plantar fascia as well as strengthening exercises for the small and large muscles of the foot and the lower leg in general.
Ultrasound helps to settle the inflammation, which in turn reduces the pain associated
with plantar fasciitis. Drug phoresis is when ultrasound is coupled with medications such as Voltaren Emulgel, instead of ultrasound gel. The sound waves drive the medication into the tissues, which results in a double effect – that of the ultrasound and the medication. From our experience this is usually superior to the use of ultrasound alone.
When it comes to strengthening exercises it is important that these include not only the muscles of the foot but of the whole lower leg. To understand why we will look at an example. Let’s say that you have weak muscles of the hips. As a result of this more load will be going through your knees and consequently through the ankle and foot, placing even more strain on the plantar fascia. Consequently, even if you treat the plantar fasciitis the risk of having a flare up in the future will be much greater than if the muscles of the whole lower leg are working well.
Margarita Gurevich is Senior Physiotherapist at Health Point Physiotherapy. She completed B.Phty degree at La Trobe University and Diploma of SCENAR Therapy in Moscow SCENAR Centre. Margarita extensively uses Clinical Pilates, SCENAR therapy & other evidence-based techniques, including Real Time ultrasound and McKenzie treatment. She specialises in Sports Injuries, Women’s Health (including incontinence) and gastrointestinal issues.