Plantar fasciitis or ‘heel pain’ is inflammation of the ligamentous band (the plantar fascia) that runs from your heel of your feet, through the arch and into the toes. The inflammation is often caused due to tearing or repetitive pulling of the fascia. It is the most common condition we see here at Border Podiatry Centre and successfully treat.
What can cause the inflammation?
- High arched foot also is known as pes cavus or flat feet known as pes planus
- Feet that roll in our roll out too much (pronation and supination)
- Feet that are unable to roll in properly
- Injury from impact or trauma
- Tight muscles – including calf muscles, hamstrings and tight plantar fascia
- Weak gluteal muscles – especially the gluteus maximus (the big butt muscle)
- A change in footwear
- Increase or change in activity
- Weight gain (this is quite common during pregnancy)
How do I know if I have plantar fasciitis?
- Pain on the bottom of the heel or inside of the arch
- Pain during prolonged standing
- Pain on initial standing after sleep or prolonged sitting
- Sharp, stabbing, pulling pain
- A bruised feeling under the heel
So What is the Big Deal?
A little while ago a news article was released stating that ‘sham’ or fake orthotics are just as beneficial as custom orthotics for the treatment of plantar fasciitis. This has created some controversy throughout the podiatry community as to why are practitioners prescribing custom devices if they provide the same outcome as off the shelf devices?
Off the Shelf devices vs. custom orthotics
Off the shelf devices are a ‘one size fits all’ device. The idea is that everyone who has the same size foot has the same shape foot. We know this not to be the case. Don’t get me wrong, they are still widely used, and we prescribe them daily here at Border Podiatry Centre if we feel they are going to achieve the desired outcomes.
Custom orthotics are designed from a scan or cast of your feet and made for your specific biomechanical needs and specific podiatric pathology. There is less “guess” work with custom made devices and they are generally more forgiving when fitting into footwear as they can be designed with everything incorporated into them. We don’t need to add things to them like off the shelf devices.
Why does podiatrist prescribe custom devices?
Whilst prefabricated devices do provide immediate relief from heel pain, they do not necessarily treat the underlying cause or causes. It is also important to remember that plantar fasciitis symptoms will improve over time without treatment- however, if the root cause is not addressed then it will keep occurring. Each episode is generally worse than the last.
Custom orthotics will fit better as they precisely mould to the contours of your foot. They are influential in being able to better align the lower limb and its movement in combination with the rest of the body. A prescribed device also allows for customisation of the type and thickness or combination of materials. As these materials are usually of a firmer density, custom devices also last longer.
THE RESEARCH
What do the guidelines say?
A combination of therapies is beneficial which include bit not limited to:
- Manual therapies including foot mobilisation and massage
- Stretching of the plantar fascia and calf
- Taping of the foot and calf
- Orthotic devices (custom or prefabricated) that support the arch and cushion the heel
Our way – The Border Podiatry Centre Way!
At Border Podiatry Centre we don’t just treat the presenting complaint, we also treat the underlying cause or causes. Anyone can treat purely the symptoms but that is not really a long term option. Our comprehensive biomechanical assessments and podiatry assessments allows our podiatry experts to design a recommended action plan specific to you, your lifestyle, your desired outcomes and your specific causes.
At Border Podiatry Centre, we scan and design the devices and then print them from the ground up. We don’t take things away, we manufacture them specifically for you and your feet. Border Podiatry Centre designed 3DO orthotics which are custom 3D printed from the scans of your feet to meet your unique needs and prescription during a weight-bearing or semi weight bearing scan. Our aim is to heal you heel pain keeping you pain free for years to come.
If you are suffering heel pain or feel a consultation with one of our expert heel pain Podiatrist will give you back your lifestyle you are craving call (02) 6024 5577 to book your appointment.
(Adapted from Sole Therapy – TREATMENT FOR HEEL PAIN: THE CONTROVERSY, THE RESEARCH, THE SOLE THERAPY APPROACH)