The Plantar Fascia
The plantar fascia ligament helps support the bones of your foot and absorb the loading forces associated with standing, walking, running… Heel pain associated with the plantar fascia and plantar fasciosis can be quite a disabling condition. Typically this type of heel pain is felt at it’s worst first thing in the morning or moving after you have been sitting or standing still for long periods. This heel pain is commonly felt under your heel bone but some people also may experience pain associated with the plantar fascia in the arch of their foot or on the outside aspect of their foot. Some people may also have mild swelling, redness and tenderness on palpation of the bottom of the heel as well as an impaired ability to ambulate.
Is It Plantar Fasciitis Or Plantar Fasciosis?
Plantar fasciitis refers to the inflammation stage of plantar fascia associated heel pain where as plantar fasciosis refers to the degeneration phase of plantar fascia associated heel pain. In most cases plantar fasciitis tends to progress to plantar fasciosis which is why the term plantar fasciopathy is considered most appropriate for this type of heel pain.
The inflammatory phase and degenerative phase of plantar fasciopathy need to be managed differently thus it is important before proceeding with treatment the phase of the condition is recognised from the outset.
Plantar fasciosis can involve stretching, tearing, and degeneration (deterioration) of your plantar fascia at its attachment site where your plantar fascia attaches to your calcaneus, or heel bone. This degeneration in the condition plantar fasciosis often occurs as a result of repetitive stress following on from plantar fasciitis.
Commonly X-ray findings may discover a bone spur and this may be suggested as a cause of your heel pain. If a heel spur is present it is probably not the cause of your pain but evidence that your plantar fascia has been exerting excessive force on your heel bone.
Heel spurs are the formation of calcium (bone) within the plantar fascia occurring adjacent to the heel bone. Patients with heel spurs present may frequently have a longer rehabilitation period due to both the period of time and the severity of the stress that has been placed on the plantar fascia tissue.
Correct Diagnosis Is Key
Correct diagnosis of your heel pain by a physiotherapist or podiatrist is important as there are a number of differential diagnosis for heel pain that present in a similar fashion to plantar fasciopathy. In most cases plantar fasciopathy will resolve without the need for cortisone injections, surgery or other invasive treatments. Conservative management including orthotics, taping techniques, stretching and strengthening exercises, acupuncture and dry needling, massage and soft tissue techniques as well as joint mobilizations usually is enough to get on top of plantar fascia associated heel pain.
Radial Shockwave Treatment For Plantar Fasciosis
Something that at Sydney Physio Clinic we have found very useful in the treatment of plantar fasciopathy in the plantar fasciosis stage is the use of radial shockwave treatment. Just like with most tendinopathies, the use of shockwave treatment can be a really effective approach with plantar fasciopathy. Radial shockwave treatment helps kick start the bodies natural healing process and is ideal for treating chronic soft tissue complaints as well as addressing heel spurs (calcification). At Sydney Physio Clinic we have a radial shockwave therapy machine which can easily be incorporated into any individuals plantar fasciopathy rehabilitation program for the treatment of chronic heel pain.
Disclaimer: Sydney Physio Clinic does not endorse any treatments, procedures, products mentioned. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific advice or assistance regarding Plantar Fasciitis Verses Plantar Fasciosis should consult his or her orthopaedic surgeon, general practitioner, sports medicine specialist or physiotherapist.