Ankle / Foot
Plantar Fasciitis / plantar heel pain / plantar fasciopathy
Pain is worse when you start walking after prolonged periods of resting, for example getting out of bed in the morning. For some, exercising and walking may help alleviate the pain, however for others this may exacerbate the pain. For some people there can be no evident cause of this issue but factors such as older age, higher weight, issues with foot and ankle biomechanics, trauma to the foot and those who spend a lot of time on their feet for both occupation and recreational activities. Your physio will take a detailed history in order to diagnose and find out the root cause of your issue before treatment begins. Treatment generally consists of specific exercises to target the painful area and its root cause. Your physiotherapist will advise regarding pain management and potentially suggest use of orthotics. As a second line option here at the clinic we also use shockwave therapy which has been proven to provide excellent results when it comes to plantar foot pain. These symptoms usually resolves within 6 to 18 months without treatment. With accurate precautions and consistent therapy, the 95% of people with plantar fasciitis are able to recover within 6 months.
Stress fractures are a type of fracture that can develop over time verses a sudden trauma. Small micro fractures can occur through repetitive loaded activity. If they are not allowed to heal and are subjected to further loading then the micro fractures remain an increasing symptom. Symptoms may include a gradual onset of “tooth aching” pain, tenderness when palpated and pain on “normal” activities such as walking. The main causes are linked to overuse injuries such as running or sports involving high levels of endurance. People who are at risk of developing a stress fracture are those who have changed surface or increased their training load. A physiotherapist will be able to assist in diagnosing these symptoms and that will involve imaging the painful area. Once confirmed appropriated management will be advised and support provided with a graded return to your activity.
Morton’s neuroma is classed as a compressive neuropathy (pinching of nerve tissue) commonly affecting the 3rd webspace of the foot. It can also affect the other web spaces. Symptoms include burning and aching pain in foot spreading to 3rd and 4th toes. These symptoms are normally aggravated with walking or running.
Generally, more females than men experience this condition with research linking an association to footwear eg wearing heeled shoes or narrow footwear that can increase the risk.
Physiotherapy has been shown to help in a number of ways. Manual therapy can increase range of movement around the foot that might be applying increased pressure to the toes during walking. Additionally, Physiotherapists can advise on footwear and provided exercises targeted to stretch or strength areas that contributing to the symptoms. If symptoms are not improving Physiotherapists are well placed to work with or referral on to other services to trial alternative treatments (Podiatry and orthopaedics).