In the last few weeks, we have been sending out our video series on the importance of foot health. Today we conclude the series with one of the most common conditions regarding feet that we see at our clinic: Plantar fasciitis (PF), also known as Jogger’s heel. So, let’s have a closer look into this debilitating problem.
What is Plantar Fasciitis?
PF is the most common cause of chronic inferior heel pain, especially at middle age. About 10% of our population will experience heel pain at some stage in their lifetime.
The plantar fascia is a thick, fibrous tissue that originates at the inside of the heel bone and runs to the base of your toes. PF is an inflammation of this fascia, often causing stabbing pain in the bottom of your foot near the heel. With tight ankles and weak foot muscles, you have to bear the load of movement through your foot which puts tension on the fascia causing small tears.
What are the Symptoms of Plantar Fasciitis?
Plantar fasciitis causes pain in your heel. It’s usually worse when you take your first steps after awakening or after you’ve been sitting for a long time. It tends to feel better with activity but worsens again after you spend a long time on your feet.
Causes and Risk Factors of Plantar Fasciitis
The thick fascia supports the muscles and arch of your foot. It’s there to support the medial arch of your foot and builds a continuous structure with the Achilles tendon. The leading causes, as well as risk factors for this condition, are activities or conditions that place a lot of stress on your heel and surrounding tissues such as:
- Obesity (more load that you can handle leading to overload)
- Middle age
- Long-distance running
- Flat feet or high arches
- Shortened Achilles tendon
- Tight ankle joints with limited dorsiflexion (flexion of the foot in an upward direction)
How do you Diagnose Plantar fasciitis?
Generally, the diagnosis is based on physical examination by checking the tender areas of your foot and determining lifestyle factors. Usually, no imaging tests are necessary, an ultrasound can clarify the diagnosis by displaying the thickened fascia (2). Occasionally, an X-Ray or MRI is needed to exclude other possible causes of heel pain.
How is Plantar Fasciitis treated in Western Medicine?
· Pain relief medications such as ibuprofen and paracetamol
· Orthotic support with heel pads and arch support
· Night splints to wear while sleeping
· Ice packs
· Ultrasound, Laser, Shockwave therapy
· Physiotherapy with specific stretches and progressive external loading
· Steroid injections in your heel (3)
How can we help at Ondol clinic with Plantar Fasciitis?
· Stretching exercises and movement therapy (Sotai) for hip and ankle mobilisation
From a holistic point of view, PF is not so much a problem with your foot but more about how you are using your feet. It is an overloading problem of the fascia and an underloading problem of the foot and calf muscles, which are pivotal to support the arch directly but are commonly weak. The hip is also often involved in the process. Too much sitting or walking in shoes with a stiff sole can create problems. Sitting impairs the ability of the hip joint to create the right torque at the hip; wearing rigid and narrow shoes tighten the ankles; both factors can lead to a detrimental effect on the function of the foot.
The treatment of PF has to be distinguished into short-term and long-term treatment. In the beginning, when pain is severe, rest, orthotics and anti-inflammatories can be helpful. We suggest trying Turmeric, Boswelia and PEA powder for pain relief and inflammation.
A systematic review evaluating all clinical trials on acupuncture for plantar fasciitis concluded that acupuncture is an effective treatment for PF. The treatment outcome is comparable to other commonly-used interventions, such as stretching, night splints and cortisone injections. (4) Accordingly, the US Department of Veteran Affairs (5) and the Acupuncture Evidence Project (6) concluded that acupuncture has a potentially positive effect for treating heel pain.
Once the acute pain has decreased, we need to mobilise and strengthen the foot and surrounding structures with specific stretches and loading exercises (7) to help to control the arches of the feet and offload the fascia. Additionally, to the course of acupuncture treatments, Bamboo steppers and toe spreaders are ideal tools to mobilise and tone foot muscles. If you haven’t seen our videos on these tools, please click HERE for our video on the bamboo steppers, or HERE for the video on toe spreaders.
We can help you with a program to support your foot mechanics.
Tips to Prevent Plantar Fasciitis:
· Maintain a healthy weight
· Wear shoes with a wide toe box and a flexible sole, which helps to let your feet ‘feel the surfaces’ they walk on
· Avoid high heels
· Try a low impact sport like swimming or bicycling
· Stretch your arches and ankles to increase strength and mobility
For more information on how we can assist you, please call us or book an appointment directly online.
4. Clark, R. J., & Tighe, M. (2012). The effectiveness of acupuncture for plantar heel pain: a systematic review. Acupuncture in Medicine: Journal of the British Medical Acupuncture Society, 30(4), 298–306.
5. Hempel, S., Taylor, S. L., Solloway, M. R., Miake-Lye, I. M., Beroes, J. M., Shanman, R., et al. (2014). Evidence Map of Acupuncture. Washington (DC): Department of Veterans Affairs.
6. McDonald, J. L., & Janz, S. (2017). The Acupuncture Evidence Project, 1–81. Retrieved from https://www.acupuncture.org.au/OURSERVICES/Publications/Acupuncture EvidenceProject.aspx