Case Study - Plantar Fasciitis & Achilles Tendonitis

Heel Pain and Plantar Fasciitis

Plantar fasciitis is the most common cause of heel pain evidenced in our Sydney heel pain clinic to date. The condition affects women more than men and commonly occurs in people aged approximately 50 years. Occasionally, younger people will present with heel pain from plantar fasciitis but this is less common. Heel pain amongst children is usually from Sever’s disease, but it is not impossible for children to develop plantar fasciitis too. Runners and athletes alike, aged 20 to 40 years, will also develop the condition, but for different reasons. Other causes of heel pain are conditions such as Achilles tendonitis and sometimes peroneal tendonitis. However, approximately 75 to 80% of all new patients presenting to our clinic, are diagnosed with plantar fasciitis.

Plantar Fasciitis Symptoms

Plantar fasciitis usually causes pain in the heel first thing in the morning when the foot hits the ground. After walking around approximately 10 to 15 minutes the heel pain subsides. To this end, plantar fasciitis often goes untreated due to the fact that there is often little or no pain throughout the day. It is not uncommon to see a new patient who has been suffering with a mild but chronic case of heel pain for more than one year. Eventually, the condition progresses and becomes more painful throughout the day, not just in the mornings. Patients will tend to feel pain after being seated and often during driving. After standing up from a seated position, the patient usually feels heel pain from the plantar fasciitis and this will cause them to hobble somewhat. As the pain level increases, patients then begin to seek treatment. In extreme cases the chronic becomes acute as the pain level intensifies. If the load on the plantar fasciitis is great enough, then micro tears, laminar tears, deep surface tears, and partial thickness tears can be seen.

Heel Pain Treatments

There are many different treatments for heel pain and plantar fasciitis, and treatments can differ from modality to modality. Physiotherapists, podiatrist, chiropractors, acupuncturists and other allied Health practitioners or specialists, will have a different approach when recommending treatment plans. Sports podiatrists have a special interest in the foot, and often treat heel pain on a regular basis. At the Sydney heel pain clinic, we have a variety of treatment options for plantar fasciitis and the podiatrist will select one based on the severity of your condition. They will also take into consideration other physical and biomechanical findings that are picked up, on the day of consultation and assessment. The types of treatments that the podiatrist will offer ranges from orthotic therapy, strapping techniques, stretching techniques, footwear recommendations, shock wave therapy and dry needling. Occasionally there will be the requirement for the patient to use an immobilisation boot in order to rectify the plantar fasciitis, if it is a cute. At Sydney heel pain clinic, we try to avoid using injections therapy for plantar fasciitis but on occasions it is required. Sydney heel pain clinic have also developed a mobile phone application which contains very specific information surrounding the treatment of all conditions that cause heel pain. The conditions that are contained in the app are as follows: plantar fasciitis, Achilles tendonitis, insertional Achilles tendinopathy, retro calcaneal bursitis and Sever’s disease.

All patients at the Sydney heel pain clinic are assessed thoroughly and are referred for an ultrasound if necessary. The podiatrist has the option to carry out a detailed biomechanical assessment using a treadmill and digital software, in order to assess foot function and to assist in determining the cause of the plantar fasciitis. Detailed footwear assessments are also carried out frequently, as incorrect footwear is often the cause of heel pain.

Shock Wave Therapy for Plantar Fasciitis

One of the more up-to-date treatments for plantar fasciitis is shockwave therapy. In fact, shockwave therapy is excellent for other heel pain conditions too, such as peroneal tendonitis and Achilles tendonitis. Shockwave therapy is a treatment that stimulates blood flow and has been found to promote revascularisation within the affected area. The increase in the number of small blood capillaries in the area is thought to improve nutrition within the affected tissue, therefor assisting in healing. Shockwave therapy was originally used to treat kidney stones but more recently has become popular in the sports medicine industry. Following a session of shock wave therapy, patients often report a drop in heel pain. This is due to the fact that the treatment reduces a chemical substance with in the heel that allows pain stimulus along the nerves. While shockwave therapy is not used to cause temporary pain relief this is still a beneficial side effect. In cases whereby a patient presents to the heel pain clinic within the first week or two of feeling pain, one session of shockwave therapy is sometimes enough to eradicate the condition. However, more often than not, patients presenting to the clinic have been suffering with plantar fasciitis for several months and a minimum of three sessions is usually required.

Sydney Heel Pain Mobile App

The Sydney heel pain mobile phone application contains information that helps patients avoid performing home remedies that can cause short term relief but long term irritation. Listed within the application are several other important points that’s steer patients in the right direction, and encourage them to do things that unload the plantar fascia and allow the healing to take place more quickly.

Patients suffering with plantar fasciitis or other causes of heel pain do not need a GP referral to come to the clinic. All treatments have a code that is recognised by private health insurance companies. The podiatrists at the clinic are all registered with all private health insurance companies within Australia. There is a hicaps machine on site at the Martin Place clinic which allows patients to claim instantly.

If you are suffering with plantar fasciitis or any other cause of heel pain please send an email to help@sydneyheelpain.com.au or call 9388 3322. We have availability at a variety of suburbs throughout Sydney.

Written by Karl Lockett