What is Plantar Fasciopathy:
The plantar fascia is a thick fibrous ligament that runs from the heel to the toes. Its main function is to support the arch of foot and provide shock absorption during walking.
Plantar fasciopathy accounts for 80% of all heel pain. It is an overuse injury stemmed from repetitive micro-trauma that lead to micro-tears and degeneration on the plantar fascia. The sensation of pain generally eases as the person warms up with movement. But if left untreated, pain may be experienced during activity.
What are the risk factors?
- On feet for extended periods
- Suboptimal foot structures
- Overweight or obese
- Shoes with inadequate support
- Late stage of pregnancy
How can we help?
The good news is that plantar fasciopathy is treatable under conservative management. In fact, 90% of the people significantly improve their symptoms within 3 months of conservative therapy. While no single treatment has been proven to be most effective, a combination of different therapies is utilised for the successful treatment of plantar fasciopathy.
When you visit a physiotherapy clinic, you may be provided with a range of techniques including:
Activity modification: Monitor the amount of standing and walking, by taking breaks before onset of moderate foot pain.
Relax the tendon: Apply ice for 10-15 minutes every 3-4 hours at the arch of the foot or roll a frozen bottle under the foot. In addition, stretching out the plantar fascia, Achilles tendon, calf muscles may all help to reduce tension under the foot.
Manual therapy: Apply joint mobilisation to loosen stiff joints, soft tissue massage to loosen up surrounding muscles.
Promote healthy living: Educate people with low impact cardiovascular exercises such as swimming and cycling, as these exercises help to reduce weight and also lessens impact on the foot. In addition, strengthening the foot and leg muscles allow the foot to have better mechanics.
Taping: Taping is effective in providing temporary relief by reducing fascia strain but is ineffective for chronic pain management.
Orthotics: Orthotics is a long-term management strategy to provide foot arch to reduce tension of the ligaments.
Night splints: It is a splint that people wear at night to pull the ankle up. It provides prolonged stretching of plantar fascia and Achilles tendon.
Medication: If the person is experiencing significant amount of pain, they may obtain non-steroidal anti-inflammatory drugs.
Shockwave Therapy: If symptoms persist for more than 3 months, Shockwave Therapy also known as Extracorporeal Shockwave Therapy (ESWT) would be recommended. ESWT is a safe and effective treatment for chronic plantar fasciopathy.
A FURTHER NOTE ON ESWT
A study done by Aqil and colleagues (2013) analysed 4 research articles on the effectiveness of ESWT on the treatment chronic plantar fasciopathy. The researchers have concluded that in addition to providing immediate pain relief, ESWT was very effective in promoting long-term tendon and ligament repair.
A 2016 study published in BioMed Research International Journal examined the long-term success rate and recurrence rate of plantar fasciopathy after receiving ESWT treatment. They defined “success rate” as the percentage of patients having more than 60% reduction in Visual Analogue Scale (VAS). VAS is a measurement instrument of patient self-reported pain intensity scale. The study found that ESWT had success rate of 98% and recurrence rate of 8% at 1 year follow up. Therefore, ESWT is a highly recommended modality of treatment for people with plantar fasciopathy.
At Back in Motion, Point Cook, we have “The Swiss DolorClast® Method ESWT” device. This is the only ESWT device approved by both the United States of America Food and Drug Administration and the European Economic Area CE mark. For more information on “The Swiss DolorClast® Method ESWT”, please visit: https://www.ems-dolorclast.com/en
THINKING FORWARD
If you or anybody you know may have plantar fasciopathy, then do not hesitate to book an appointment at Back in Motion, Point Cook. All our physiotherapists can help to assess and treat your condition, so that you may enjoy a better quality of life.
Author: Tony – Physiotherapist at Back In Motion Point Cook