Presentation: plantar fasciitis

A 47 year old male presented to the Sydney Heel Pain Clinic requesting plantar fasciitis treatment. He reported heel pain in both feet for at least 7 or 8 months. He was otherwise fit and healthy. The patient told the sports podiatrist that he had increased his running distance lately and he had added 2 extra training days in preparation for his workplace charity fun run. He was running 6km five days per week when the plantar fasciitis kicked in.

Pain symptoms were consistent with plantar fasciitis

When asked to describe his pain from the plantar fasciitis, the patient said it was very sharp and deep in the centre of the base of his heel. He said that his heel pain was always very bad first thing in the morning when he got out of bed but usually subsided after a few minutes of walking- a classic sign of of plantar fasciitis. The patient told the sports podiatrist that he was able to run with bearable pain after around 5-10 minutes of starting. The patient was particularly concerned that once he had finished running, his heel pain would become severe.

The patient had tried some home remedies for plantar fasciitis

The patient informed the sports podiatrist that one of his colleagues had mentioned he may have plantar fasciitis, and based on that, he had done some reading on the internet which led him to try some home remedies to relieve his heel pain. He had been using ice packs to ice his feet following his training. He had also purchased some over-the-counter orthotic inserts that the pharmacy assistant had suggested may be helpful for plantar fasciitis. He confessed to the sports podiatrist that these orthotics were actually quite uncomfortable and he did not wear them consistently.

Evaluation of plantar fasciitis in the patient

A thorough physical examination was carried out by the sports podiatrist in order to evaluate the severity of the plantar fasciitis. The patient reported a lot of pain around the plantar aspect of the heel as the sports podiatrist palpated his foot. This is the area where the plantar fascia ligament attaches to the heel bone. The sports podiatrist discovered that the patient also had tight calf muscles in both legs, which was limiting the range of motion in the patient’s ankles, hence putting pressure on the plantar fascia. The sports podiatrist informed the patient that his signs and symptoms were consistent with a diagnosis of plantar fasciitis.

Biomechanical assessment for plantar fasciitis

A biomechanical assessment and gait analysis was carried out during the initial consultation as part of the examination for plantar fasciitis. The biomechanical assessment is a useful tool in assisting the sports podiatrist to identify malalignments, imbalances and abnormalities in the patient’s legs and feet as they walk. This information is often used to form the basis of the treatment plan, since plantar fasciitis is often caused by chronic overuse of the plantar fascia ligament due to suboptimal gait. The patient’s arch height and heel position were also measured.

Plantar fasciitis treatment for the patient

A treatment plan was devised for the patient’s plantar fasciitis, with the aim being to reduce inflammation and relieve heel pain, whilst allowing the plantar fascia ligament to heal. The sports podiatrist devised a treatment plan comprised of three main components:

1. Stretches for the tight calf muscles
2. Custom-made orthotic inserts
3. Shockwave therapy.

The patient was prescribed a series of particular stretching exercises by his sports podiatrist. The exercises were particularly selected to assist with increasing flexibility in the calf muscles, which would reduce the strain on the plantar fascia and therefore allow the ligament to heal.

Custom-made orthotics were ordered for the patient. These would assist in the healing of his plantar fasciitis by controlling and supporting the arch of the foot, without putting too much pressure on it. The patient was advised that he would need to wear the orthotics every day for 6-8 weeks. In this time frame, it was expected that his heel pain would resolve and the plantar fascia ligament would begin to heal.

Shockwave therapy treatment was scheduled for this patient once a week for four sessions. Shockwave therapy is a scientifically proven treatment for plantar fasciitis. It works by directing high frequency sound waves into the area, which stimulates blood flow, tissue regeneration and breakdown of scar tissue, whilst also providing almost instantaneous pain relief.

The patient was advised by his sports podiatrist that he would need to refrain from running for the next 3 to 4 weeks whilst he underwent his treatment for plantar fasciitis. The sports podiatrist suggested that in the meantime, he could walk or lightly jog for short intervals only, provided that he followed his prescribed stretching regime closely.

Shockwave therapy for plantar fasciitis treatment: the outcome

The patient returned to the clinic one week after his initial consultation, to have his custom orthotics fitted and to receive his first shockwave therapy treatment. The patient reported immediate pain relief at the cessation of the first shockwave therapy treatment.

The patient’s following shockwave therapy treatment for plantar fasciitis was scheduled for one week later. He informed the sports podiatrist that whilst he’d experienced immediate pain relief following his last treatment, the following morning he had the same severe heel pain. The sports podiatrist reassured him that this was normal and that the therapy can take a number of sessions to take effect. His second shockwave therapy treatment also provided him instantaneous pain relief. At this second therapy session, the patient also reported that he was becoming accustomed to wearing his orthotics. He had been compliant with the stretching regime that the sports podiatrist had prescribed for him.

The patient received two more shockwave therapy treatments for his plantar fasciitis in the following two weeks.

The patient returned to the clinic for a follow-up consultation with the sports podiatrist eight weeks from the initial consultation. The patient reported that his pain from plantar fasciitis had almost completely resolved. The sports podiatrist advised him that he could begin to run again, only over short distance intervals to begin with. He was told to slowly increase his running distance (by no more than around 10% per week).

Please bear in mind that this case study is unique to the individual patient as described. Treatment details should not be taken as general medical advice. If you are suffering with plantar fasciitis or any type of heel pain, you should consult with a qualified sports podiatrist for an accurate diagnosis and individualized treatment plan.

Podiatrist Karl Lockett
Sydney Heel Pain Clinic
93883322
help@sydneyheelpain.com.au

Written by Karl Lockett

Presentation: Plantar Fasciitis

A 27 year old male presented at the Sydney Heel Pain Clinic, experiencing heel pain in both feet and his symptoms were indicative of plantar fasciitis. The patient advised the sports podiatrist that his heel pain had been present for around 8 months that he could recall. He was overweight (BMI>30) but otherwise had no serious health concerns. He had a mostly sedentary lifestyle, working a desk job five days per week and enjoying video games on the weekends. The patient and his girlfriend had recently adopted a new dog and had begun taking it for walks in the evenings, however the patient often experienced heel pain and it discouraged him to be active. His girlfriend encouraged him to visit the sports podiatrist for a correct diagnosis as she said it sounded like plantar fasciitis.

Patient’s Pain Symptoms: Consistent with Plantar Fasciitis

The patient described heel pain that was consistent with a diagnosis of plantar fasciitis. The patient described his pain as feeling like a stabbing at the base of his heel. His pain was very bad first thing in the morning as he got out of bed. It would subside and feel more like a dull aching after some time of moving around. During the day, he would feel the sharp heel pain again when he would rise from his desk chair after being seated for some time. On the occasions that the patient would walk his dog, his pain would return after he finished exercising. The sports podiatrist informed the patient that his heel pain symptoms were typical of plantar fasciitis.

Plantar Fasciitis Examination and Assessment

In order to confirm his suspicion of plantar fasciitis, the sports podiatrist carried out a thorough examination. He began with a comprehensive list of questions regarding the patient’s pain symptoms, medical history and physical activity habits. The sports podiatrist examined the patient’s feet. The range of motion and strength in the foot and ankle joint were assessed, as well as the flexibility of the patient’s lower leg and foot muscles, ligaments and tendons.

The patient was asked to have an ultrasound to aid the sports podiatrist diagnosis of plantar fasciitis, and to exclude any other injury or abnormality that may be causing the patient’s heel pain. He returned the following week with his results.

Biomechanical Assessment for Plantar Fasciitis

As part of the sport’s podiatrist’s assessment of the patient for plantar fasciitis, he carried out a biomechanical and gait analysis. The in-house treadmill at the clinic was used to perform this. The assessment involved placing some markers on the patient’s lower leg and foot and then recording footage of the patient walking on the treadmill. The sports podiatrist was then able to review the patient’s foot strike in slow motion and detect malalignment or functional abnormalities. Heel angle and foot arch height in the patient’s feet were also measured.

Notable findings of the examination for plantar fasciitis

• The patient reported strong pain when the sports podiatrist applied pressure to the plantar aspect of the heel (the approximate location where the plantar fascia ligament connects to the heel bone)
• The patient had poor flexibility in his calf muscles
• The patient exhibited pes planus (fallen arches)
• During the biomechanical assessment, the patient exhibited increased foot width and it was determined that there was peak pressure from weight bearing during walking under the longitudinal arch
• The patient had increased plantar fascia thickness (4.9mm), evident on the ultrasound, confirming a case of plantar fasciitis.

Diagnosis Confirmed: Plantar Fasciitis

The sports podiatrist informed the patient that he had plantar fasciitis: inflammation of the plantar fascia ligament due to chronic overuse.

Treatment for Plantar Fasciitis

Once the patient’s plantar fasciitis diagnosis was confirmed, treatment could begin. The main goal of the treatment for his heel pain was to reduce strain on the plantar fascia and relieve the patient’s pain, while at the same time, allowing the plantar fascia to heal.

The recommended treatment plan comprised five main components:

1. Stretching the patient’s tight calf muscles
2. Taping for plantar fasciitis
3. Custom shoe inserts
4. Shockwave therapy
5. Weight loss.

The sports podiatrist demonstrated to the patient which exercises he should perform to help increase flexibility in his calves, which would reduce the strain on the plantar fascia. The patient was instructed to carry out his stretches three times daily, especially before bed.

The sports podiatrist also instructed the patient on how to strap his feet in a way that would support his arches and unload the plantar fascia, providing pain relief and allowing it to heal. Custom shoe inserts were arranged for the patient. The sports podiatrist explained that the custom orthotics the patient would receive would touch and hold the sole of the foot, unloading the plantar fascia and allowing it to heal. The sports podiatrist recommended that the patient should wear his custom orthotics on a daily basis for 6-8 weeks. This would help to relieve his pain in the short term but also allow the plantar fascia to heal in the longer term.

Shockwave therapy was recommended for this patient’s plantar fasciitis treatment. It is an evidence-based treatment for the condition. It has the potential to offer the patient instantaneous pain relief. Shockwave therapy works by stimulating tissue regeneration and encouraging blood flow to the injured or inflamed area. The patient received four shockwave therapy treatments over the course of four weeks.

The sports podiatrist discussed maintaining a healthy body weight with the patient. He encouraged his patient to try to lose some weight, as extra bodyweight puts a lot pressure on the structures in the feet, often causing foot and heel pain. Scientific studies have shown a statistically significant relationship between increased BMI (body mass index), fat mass, and foot pain². Further studies also demonstrated that patients with chronic plantar heel pain were almost three times more likely to have a BMI of 30 or more¹. A change in diet was suggested and the patient was provided with resources for nutrition information. The patient was also advised to begin some low impact exercise (swimming was advised) while his plantar fasciitis healed, until he would be able to walk briskly with his partner and their dog again.

Plantar Fasciitis Treatment Outcomes

The patient completed his course of shockwave therapy treatments for his plantar fasciitis. He reported an immediate reduction in pain on all occasions.

He had been diligent in completing his prescribed exercises. The sports podiatrist advised his patient that he should continue to perform these in the long term so that he could maintain his flexibility, and for general wellbeing.  The patient reported that he found his orthotics comfortable, and that they seemed to be providing him with support in the right places and helping with his pain.

The patient returned for his final check up twelve weeks after his initial visit to the clinic. He reported to his sports podiatrist that on most days he was completely pain free. At that point in time, he was wearing his orthotics on most days thorough the week, and continuing to complete his stretches on a daily basis. The patient had been swimming twice a week and he had begun incorporating walking into his exercise regime three times a week. He had managed to lose a reasonable amount of weight in that time too, which was no doubt helping him to feel better overall.

Please be advised that this case study is unique to this individual patient. Any treatment details mentioned are not intended, nor should they be taken as general medical advice. If you are experiencing heel pain or suspect you might have plantar fasciitis, you should make an appointment with a qualified sports podiatrist for a correct diagnosis and treatment plan.

Podiatrist – Omar Mohamad

Sydney Heel Pain Clinic – North Sydney

93883322

References:

¹Irving, D.B., Cook, J.L., Young, M.A., Menz, H.B., 2007, Obesity and pronated foot type may increase the risk of chronic plantar heel pain: a matched case-control study, BMC Musculoskeletal Disorders, 8, 41.

²Tanamas, S.K., Wluka, A.E., Berry, P., Menz, H.P, Strauss, B. J., Davies-Tuck, M., Proietto, J., Dixon, J. B., Jones, G., Cicuttini, F.M., 2012, Relationship between obesity and foot pain and its association with fat mass, fat distribution, and muscle mass. Arthritis Care Research, 64, 262-268.

Written by Karl Lockett

Presentation- Plantar Fasciitis?

A 38 year old female presented at the Sydney Heel Pain Clinic with heel pain in her right foot, consistent with plantar fasciitis. She reported that she had been suffering with heel pain for around 6 months. The patient told the sports podiatrist that she had joined her local health club about 6 months ago and she was participating in step aerobics classes 2-3 times per week. The patient was slightly above a healthy BMI but reported that she had been steadily losing weight (she had already lost 8kg in 6 months). Occasionally (approximately once a week) she would have cramping in her calves in the evening after a big day on her feet. She was otherwise healthy. The patient was a busy mum of 3 kids, and she was concerned that her heel pain would get worse and that the plantar fasciitis would stop her from doing things with her children.

Pain Symptoms Consistent with Plantar Fasciitis

The description of her heel pain was consistent with plantar fasciitis. She described that her pain was worst first thing when she stood up out of bed. The pain felt like a stone in her heel. She said that the heel pain would subside and feel more like a dull ache after a few minutes of walking around. The patient told the sports podiatrist that her pain was manageable whilst she was exercising, but she was often so sore following her aerobics class that she would roll her foot over a frozen water bottle for relief and then spend some time lying on the couch. This provided her some temporary relief but when she stood up, she would feel the heel pain from the plantar fasciitis again.

Plantar Fasciitis Home Remedies Tried by the Patient

The patient told the sports podiatrist that she had discussed her heel pain only very briefly with the GP a couple of months ago, and the GP had mentioned that she may have plantar fasciitis, though she never returned for a proper diagnosis or treatment. She had searched ‘plantar fasciitis’ on the internet, and based on the information she’d found, she had been trying some treatments at home. The patient had been using a frozen water bottle to ice-massage her sore foot. She was also performing some stretches for plantar fasciitis that she had watched in a YouTube video, but admitted that she often forgot to do these on a regular basis. The patient had seen an advertisement on the internet about some plantar fasciitis socks, but she was unsure whether these would work. She reported to the sports podiatrist that very occasionally she would take ibuprofen if the heel pain from the plantar fasciitis became severe.

The patient’s husband recommended to her that she visit a sports podiatrist for a correct diagnosis and treatment, as he was concerned that she was becoming increasingly sore.

Examination to Assess Patient’s Plantar Fasciitis

The sports podiatrist carried out a thorough physical examination in order to confirm the diagnosis and assess the severity of the plantar fasciitis. As the sports podiatrist palpated the sore foot, the patient reported a lot of pain in the central area of heel. There was also some pain in the plantar area, where the plantar fascia attaches to the heel bone. She was able to successfully perform a single leg heel raise on the affected leg without notable pain. The sports podiatrist performed some further physical tests on the range of motion in the foot and ankle joint, and on the muscles, ligaments and tendons in the lower leg and foot. The sports podiatrist’s examination revealed tight calf muscles in the patient’s legs, but more so in the right leg. No further abnormalities were detected.

The patient was notified that her clinical signs and symptoms were consistent with a diagnosis of plantar fasciitis, but reassured her that her condition was treatable.

Biomechanical Assessment for Plantar Fasciitis

During the physical examination for plantar fasciitis, the sports podiatrist also conducted a biomechanical assessment and gait analysis on the in-house treadmill. Markers were placed on the patient’s lower leg and foot and the footage of the patient running on the treadmill was recorded. An analysis of foot strike was then carried out in slow motion. Arch height and heel angle were measured.

Footwear Assessment for Plantar Fasciitis

Following the examination and biomechanical assessment, the sports podiatrist assessed the patient’s footwear. The patient had a pair of branded minimalistic-style running shoes, which she was using for step aerobics classes and also during running her daily errands. It was determined that her current runners were not providing sufficient support for her foot. This is likely to have been a major contributing factor in the development of the patient’s plantar fasciitis.

Commencement of Treatment for Plantar Fasciitis

Treatment for plantar fasciitis is often based around the findings of the treadmill assessment and physical symptoms. The aim of the treatment for this particular case of plantar fasciitis was to reduce inflammation and relieve pain, whilst at the same time allowing the plantar fascia ligament to heal.

The sports podiatrist devised a treatment plan with three main components:

1. Change in footwear
2. Strapping
3. Stretches for the calves and plantar fascia
4. Shockwave therapy

The patient was shown some stretching techniques by her sports podiatrist. The exercises were selected in order to help with increasing flexibility in the calf muscles- which would also help with the patient’s cramping- and releasing the foot and ankle, and therefore allow the plantar fascia to heal. The sports podiatrist explained to the patient that she should set an alarm to remind her to complete her exercises at intervals throughout the day.

In order for the plantar fascia to recover, the patient was recommended to purchase a new pair of shoes. This particular patient was advised that for her foot type, the Brooks Adrenaline GTS would be most appropriate to adequately support the architecture of the foot without placing any undue pressure on it.

Shockwave therapy is a scientifically proven treatment for plantar fasciitis. It can provide instant pain relief, encourages tissue regeneration and stimulates blood flow to the area. The patient was scheduled to receive four shockwave therapy treatments over the course of four weeks. Rigid sports tape was applied to the affected foot and was to be re applied at each session.

The sports podiatrist recommended to the patient that during her treatment for the next 6 weeks, she should not participate in step class. She was advised and choose another activity instead that would not be high-impact for her feet, making sure to warm up prior to exercising. Some options were aqua aerobics, swimming, or upper-body boxercise.

Plantar Fasciitis Socks?

With regards to the patient’s question regarding plantar fasciitis socks for treatment, the sports podiatrist advised her that there is a lack of evidence available regarding their efficacy. The patient would be receiving scientifically proven methods of treatment for her plantar fasciitis, so there would be no need to purchase plantar fasciitis socks.

Plantar Fasciitis Treatment Outcomes

The patient received her first shockwave therapy treatment on the day of consultation. She tolerated the treatment well. She reported that she experienced pain relief immediately following her treatment.

The following treatment was one week after the first. This second treatment also provided the patient instantaneous pain relief. The patient also reported that she had been completing the exercises that the sports podiatrist had prescribed.

In the following two weeks, the patient received two more shockwave therapy treatments for her plantar fasciitis.

A follow-up consultation was scheduled by the sports podiatrist for two weeks after the final shockwave therapy treatment. The patient was pain free. She reported that her new shoes felt so supportive on her feet, and she had been compliant with the exercise program that her podiatrist has suggested for her. She was advised that she could return to her step aerobics class, but should begin by using the lowest step and following the low impact option, if the class instructor gave one. If she was still pain free for 2 weeks, she could progress.

Please be advised that this case study is unique to the individual patient. Any reference to treatments should not be taken as general medical advice. If you have heel pain or you suspect you may have plantar fasciitis, you should consult with a qualified sports podiatrist for an assessment and correct diagnosis.

Book online – https://sydneyheelpain.com.au/book-online/

Podiatrist – Fatmeh Abdi

Sydney Heel Pain Clinic

93883322

 
Written by Karl Lockett

CASE STUDY OF ACHILLES TENDON PAIN

A 37-year-old male in good health, attended the Sydney heel pain clinic complaining of Achilles tendon pain in his left foot. His problem had been ongoing for approximately six months and he reports to the sports podiatrist that over the last three weeks it got much worse. The Achilles tendon pain was limited to the left ankle only and did not affect his right side. The discomfort he felt ran along approximately 3 cm of the Achilles tendon shaft, just above the heel bone itself. This patient was a keen walker and enjoyed approximately 5 or 6 km walks with his dog each weekend. During the week, he would carry out shorter walks with his wife and his dog but would also experience the Achilles tendon pain regardless. He described a significant stiffness through the left ankle in general and found each morning when rising from bad to be problematic. As is often the case, following his morning routine including a hot shower, the Achilles tendon pain subsided significantly and he was able to continue with his day-to-day duties. He reports to the sports podiatrist that following long drives or extended periods of being seated, the Achilles tendon pain would return when he stood up or started walking. This gentleman explained to the podiatrist that he would occasionally use anti-inflammatory medication and this would reduce the symptoms. He had also decided carry out some home remedies including stretching and loading exercises, but he found that these increased symptoms. The Achilles tendon pain would subside slightly following the exercises but would return with increased intensity shortly afterwards.

ASSESSMENT OF ACHILLES TENDON PAIN

The sports podiatrist carried out a routine examination of the left ankle and noted severe Achilles tendon pain on palpation when finger pressure was applied. The patient was advised that he had a condition commonly known as Achilles tendinitis and that it may be complicated by a bursitis. The insertion of the Achilles tendon at the posterior aspect of the heel bone was unremarkable and did not induce pain or discomfort on palpation. The plantar fascia was also intact and nonproblematic. The patient was informed that the cause of his Achilles tendon pain was a classic Achilles tendinitis.

WHAT CAUSES ACHILLES TENDON PAIN?

Upon examination of this patients exercise shoes it became apparent that these were the cause of his Achilles tendon pain. The shoes were old and extremely worn and had softened considerably. His shoes were providing some form of comfort and a mild form of cushioning but lacked support and control. Due to the lack of support there was an excessive amount of pronation and hyper mobility of his left foot inside the shoe during gait. This would have increased the load on the Achilles tendon and caused significant stiffness through the lower calf.

TREATMENTS FOR ACHILLES TENDON PAIN

In order to reduce the Achilles tendon pain in this patient the sports podiatrist informed the patient that his footwear must be changed immediately. The patient was measured and fitted with a new pair of ASICs gel fortitude in the clinic and was observed on the treadmill. Video footage was recorded and replayed and the new shoes were approved. The sports podiatrist demonstrated and executed with the patient, standing calf stretches with the foot supinated. The patient was asked to apply ice to the posterior aspect of his ankle on a daily basis in order to reduce irritation and inflammation, and to minimise the Achilles tendon pain.

This patient returned for a follow-up at four weeks and reported to the sports podiatrist that his Achilles tendon pain had improved significantly. He advised the practitioner that there was some residual stiffness each morning when rising from bad but that the sharp stabbing sensations and the throbbing pain had gone completely. This patient had been compliant with the application of ice packs on a daily basis and had performed regular calf stretching, all of which helps to reduce the Achilles tendon pain.

If you are suffering with Achilles tendon pain or if you think you have Achilles tendinitis please do not take the information contained in this case study as medical advice.

You should consult with a suitably qualified healthcare practitioner. The sports podiatrists at the Sydney heel pain clinic have a special interest in Achilles tendon pain and appointments can be made on the following phone number: 02 9388 3322

 
Written by Karl Lockett

A New Patient with a Plantar Fasciitis Diagnosis

A 57-year-old female arrived at the Sydney Heel pain clinic complaining of pain in the bottom of her heel and the consultation ultimately lead to a plantar fasciitis diagnosis. This lady was a keen golf player and enjoyed 18 holes each weekend. She also enjoyed off-road walking at least twice per week, but had reduced this since the plantar fasciitis diagnosis. This lady described all the classic signs and symptoms of the condition such as pain under the base of the heel which was quite prominent first thing in the morning. She explained to the sports podiatrist that she had been suffering for approximately 12 months and had not found any reliable solution. She informed the podiatrist that there was no real reason for the onset of the plantar fasciitis and that the diagnosis had been made by her GP. She explains to the sports podiatrist that her footwear had not changed and she was using the same hiking shoes and the same golfing shoes thought she had been wearing for several years. She does not recall any particular incident or accident whereby she injured her foot or her ankle. Since the plantar fasciitis diagnosis, this patient had attempted to reduce the symptoms by bathing her feet in warm water with Epsom salts and had been massaging lavender oil into the sole of her foot, to no avail. She also purchased generic arch supports from the chemist in order to reduce the symptoms of the plantar fasciitis but found that these inserts aggravated the arch of her foot and increased the plantar heel pain. She refused to use the generic arch supports any further and began to seek the help of a sports podiatrist.

This lady reports to the sports podiatrist that her GP made the plantar fasciitis diagnosis without the use of x-ray or ultrasound imaging and she was reassured that such procedures were not always necessary. The podiatrist informed the patient that following a physical examination involving mild finger pressure and palpation of key parts of the heel and foot, that the plantar fasciitis diagnosis would be confirmed or denied.

This patient also reported pain in the base of her heel after being seated for long periods of time, such as when leaving the clubhouse following golf. Long periods of standing in the kitchen when cooking also lead to severe discomfort which would lead to the patient needing to take a seat. The application of heat packs temporarily eased the symptoms but were not useful in eliminating the plantar fasciitis.

Plantar Fasciitis Diagnosis by Sports Podiatrist Confirmed

Following a routine physical examination by the sports podiatrist, who palpated key areas of the heel and arch, a definite plantar fasciitis diagnosis was made. The patient was reassured that her symptoms were typical of the condition and that once the treatment plan was executed, she would make a full recovery.

The sports podiatrist carried out a biomechanical assessment and took foot and ankle posture index measurements including arch and heel position when weight bearing and non- weight bearing. An assessment of foot and ankle joint range of motion was conducted as well as muscular function.

The sports podiatrist explained to the patient that now the plantar fasciitis diagnosis had been made she would be presented with one or combination of treatment options that would be selected based on the severity of her condition and the results from the biomechanical assessment.

Plantar Fasciitis Diagnosis – Treatment Plan

The treatment plan following the plantar fasciitis diagnosis was to include the following

1. Calf muscles release and stretch.
2. Shock wave therapy.
3. Prescription orthotics to be used inside walking shoes and golf shoes.

The patient would receive her first shockwave therapy appointment in one week’s time and would receive one every week for approximately four to six weeks.

The prescription orthotics that were designed for this patient were made using a 3D scanner and 3D printer. The design of the orthotics was such that it would not represent a traditional arch support whereby unwanted pressure is applied to the sole of the foot against the plantar fascia. This type of arch support further irritates the condition and prolongs the pain in the base of the heel. Once a plantar fasciitis diagnosis has been made, patients attending the Sydney heel pain clinic are usually fitted with an alternative style of orthotic. This type of insert helps to reverse the inflammatory heal condition within a matter of weeks. The shockwave therapy stimulates healing and accelerates the recovery process.

Please no that the information contained in this case today is related to one particular patient at the Sydney Heel pain clinic and should not be taken as general medical advice. If your doctor or other healthcare practitioner has given you a plantar fasciitis diagnosis then you should seek the help of a sports podiatrist.

Written by Karl Lockett

Sydney Heel Pain Clinic

help@sydneyheelpain.com.au

02 93883322