A NUM­BER OF THESE RISK FAC­TORS ARE UN­DER OUR CON­TROL

Great Health Guide - - GREAT HEALTH -

• Ab­nor­mal foot biome­chan­ics (e.g. hav­ing a high arch, in­cor­rect pat­tern of walk­ing and oth­ers)

• Obe­sity

• 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.

TREAT­MENT

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.

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