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Policeman’s Heel: Inflamation of tissue

Plantar Fasciitis (also known as Policeman’s heel) is the condition where inflammation of a thick band of tissue that connects the heel bone to the toes occurs.

  • Plantar Fasciitis is a condition where the plantar fascia becomes inflamed
  • Similar to denim fabric, the fascia is a rigid structure that has minimal give when stretched.
  • It is usually long enough to minimize the need to stretch it but structural changes can make it shorter or tighter, causing it to be stretched and inflamed during activities
  • Increased mechanical stresses, such as prolonged standing, walking or running can also cause it to become inflamed.
  • This leads to pain along where the plantar fascia runs at the bottom of the foot- from the heel and sometimes to the base of the toes

What are the symptoms of Plantar Fasciitis?

  • A patient with plantar fasciitis may experience gradual pain at the bottom of the foot- particularly around the heel and up to the bottom of the toes
  • It is usually at its worst after not standing or walking for a while- such as when you first get up from bed or after sitting for a long time (also called “first-step pain”)
  • It improves once you start walking around although may be painful afterwards
  • As it becomes worse, it may also be painful when walking or when you are not on your feet (ie. While you are sleeping at night)

Myth-busting misinformation to improve your health outcomes!

MYTH 1: A bony spur, known as a plantar spur, is the cause of pain in plantar fasciitis. As a result, some patients ask health professionals if they can “get rid” of the bony spur to improve the pain.

FACT: studies have found that patients without plantar fascia pain also have the spurs- hence indicating the presence of spurs is normal and not the cause of plantar fasciitis pain!

MYTH 2: Corticosteroid injections is a miracle treatment that can get rid of my plantar fasciitis pain forever!

FACT: Corticosteroid injections only help with short term pain relief and ongoing use can lead to deteriorating structural changes in the structures around the heel.

How can a physiotherapist and exercise physiologist help?

  • There are many different pathologies that can cause pain in the heel and sole of the foot
  • A physiotherapist can:
  • Confirm if the pain is, indeed, from plantar fasciitis (and nothing else!)
  • If it is plantar fasciitis, address the different causative factors that are leading it to become inflamed
  • Provide a progressive exercise program so that you can achieve your physiotherapy goals!
  • Studies have shown that weakness in particular muscles in the legs can lead to changes in the posture of foot; hence causing plantar fasciitis pain
  • After your symptoms reduce significantly with a physiotherapist, exercise physiologists can strengthen the muscles around your hips and ankle to reduce the risk of recurrence!

References:

Brukner, P., Khan, K. (2019).  CLINICAL SPORTS MEDICINE 5E – VOL 1. United Kingdom: McGraw-Hill Education.

Goff, J. D., & Crawford, R. (2011). Diagnosis and treatment of plantar fasciitis. American family physician, 84(6), 676-682.

Disclaimer:

Please remember that medical information provided by Optimum Health Solutions, without consultation with a health care professional, must be considered as an educational service only and is not a substitute for a medical consultation.

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