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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 is
the use 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
orthotics
that support
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
may be used
to manage heel
pain.
Once
the pain and
swelling has
subsided, the
patient must
do exercises
that help 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 tubigrip
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
immediate 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).
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