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Heel Pain & Rugby

 

Heel Pain & Rugby

 

Heel Pain (Plantar Fasciitis) affects the foot by causing pain in both the heel and arch of the foot. This condition involves inflammation of the muscle that runs from the heel to the toes called the plantar fascia. The plantar fascia extends from the heel bone to each of the metatarsal bones effectively covering the tiny muscles located at the sole of the feet.

The Plantar fascia is an essential structure involved in running. Once you ‘toe-off’, the Plantar Fascia contracts, becoming a lever that helps the foot exert force on the ground. Located on the arch of the foot, the Plantar Fascia is one of the fundamental structures responsible for providing stability.

Plantar fasciitis usually causes pain in the centre of the heel and is often be caused by a condition called over pronation. Over pronation is when the foot rolls in excessively which outs pressure on the plantar fascia. Rugby players can also suffer from this condition as excessive weight and rigorous activities are contributing factors Therefore rugby forwards can have a higher incidence of this condition.

Plantar Fasciitis Signs & Symptoms

Although Plantar Fasciitis starts with pain specifically in the inside of the heel it can spread to the sole of the foot. The pain typically accompanies any physical activity. The pain is usually worse when you first rise in the morning and after you have been sitting for a period of time and then rise to take the first few steps.

A podiatrist or physiotherapist can diagnose the presence of Plantar Fasciitis by checking if there is pain upon touching the inside of the heel and/or upon pulling the toes up, a procedure that stretches the Plantar Fascia. To confirm the diagnosis, an ultrasound may be preformed in order to see if the Plantar Fascia has developed a thicker appearance. In some instances, the heel pain may not respond to normal treatment. In such cases, an X-ray may be necessary to check for other conditions such as the presence of a heel fracture.

Plantar Fasciitis Treatment

Since Plantar Fasciitis primarily involves inflammation, it can only be successfully treated when the cause of the swelling is correctly determined and addressed. For rugby players it is essential to rest for 2 weeks as this condition can be a tell tale sign of over training. In this case, rest is extremely significant since it will alleviate the strain in the Plantar Fascia and facilitate healing of the affected tissues.

Another form of effective treatment for heel pain is the use of orthotics to take pressure off the fascia. Through its ability to provide pulsating compression with every step of the foot, the orthotics will be able to help alleviate the discomfort as well as enhance the circulation which will allow the swelling to subside.

In some instances, a problem with the biomechanics of the foot may be contributing to the symptoms of Plantar Fasciitis. The findings typically show that the foot may ‘over pronate’. This condition involves an excessive rolling of the inner arch of the foot at the sub taler joint. This leads to increased stress to the Achilles tendon which will in turn causes more strain to the Plantar Fascia. The use of an orthotic that supports the inner arch of the foot can help resolve this situation.

Any local inflammation or biomedical problem can be addressed by conservative treatments like physiotherapy. In this form of treatment, ice packs and doctor-prescribed anti-inflammatory tablets may be used to manage heel pain.

Once the pain and swelling has subsided, the patient must do exercises that help to stretch the plantar fascia to strengthen the muscle. An example would be first thing in the morning, loop a towel, a piece of elastic or a tubi-grip around the ball of your foot and, keeping your knee straight, pull your toes towards your nose, holding for 30 seconds. Repeat 3 times for each foot. If this exercise initiates pain than you should immediately stop.

Plantar Fasciitis may also be treated using a procedure called, taping. The application of the tape supports the Plantar Fascia and effectively reduces strain which can worsen the condition.
In the event that six months of conservative treatment is unable to improve the conditions brought by Plantar Fasciitis, surgery may be considered an option. Although surgery is not advised as an option due to the possible side effects and no long term evidence of its success.

Plantar Fasciitis Prevention

Plantar Fasciitis is often linked to improper footwear. The shoes used should be able to give the foot sufficient support. Use of inadequate footwear when playing rugby may increase strain on the Plantar Fascia, which can for that reason lead to pain and swelling.

To relieve stress on the plantar fascia, it is ideal to use insoles that support the inner side of the foot. These insoles can also protect the foot from unnecessary pronation (foot rolling over too much).

HEEL PAIN TREATMENT

 

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