Here at Dynamic Osteopaths & Regenerative Medicine in Solihull We treatment every condition we see with a potential solution. Here, we will cover the treatment of planter fasciitis.
Planter fasciitis and heel pain is one of the most common forms of foot pain in adults. The heel bone is the largest bone in the foot and the heel is the first part of the foot to contact the ground during walking. The plantar fascia is a thick, broad, inelastic band of fibrous tissue that courses along the bottom surface of the foot. It is attached to the heel bone and fans out to attach to the bottom of the metatarsals (foot bones) in the region of the ball of the foot. Because the normal foot has an arch, this tight band of tissue (plantar fascia) is at the base of the arch. It supports the arch of your foot and also acts as a shock- absorber in your foot.
Plantar fasciitis is an, usually chronic, inflammation of your plantar fascia and is most commonly a result of repeated trauma to the fascia at the point where it attaches to the heel. This condition can be hugely painful and affects many normal functional tasks.
PLANTER FASCIITIS
Plantar fasciitis is common. Around 1 in 10 people will get plantar fasciitis at some time in their life. It is most common in people between the ages of 40 to 60 years but can occur at any age.
It is twice as common in women as in men. It is also common in athletes. You are more likely to injure your plantar fascia when you do a lot of walking, running or standing without being used to it. It is also highly associated with poor footwear. Athletes who increase running intensity, change shoes, train on different soils or increase training distance may also develop a plantar fasciitis
When you suffer from a plantar fasciitis, pain is the main symptom, and pain can be especially felt first thing in the morning. This can be anywhere on the underside of your heel. However, commonly, one spot is found as the main source of pain. This is often about 4 cms forward from your heel, and may be tender to touch. The pain is often worst when you take your first steps on getting up in the morning, or after long periods of rest where no weight is placed on your foot.
Sudden stretching of the sole of your foot may make the pain worse. For example, walking up the stairs or on tip-toes. Some people have plantar fasciitis in both feet at the same time which can be hugely uncomfortable.
Tendons are known to have a poor blood supply. Combined with the stress of day-to-day activities, they do not easily heal from damage. As a result of the slow healing of tendons, the symptoms occurring at a plantar fasciitis can last for a number of weeks, months, or sometimes, they can persist up to years.
Common treatments for a Plantar Fasciitis
• Rest from stressful activities • Physical rehabilitation program • Heel cups/pads • PRP treatment • Shockwave therapy • Acupuncture
It is not uncommon for this condition to be extremely painful, chronic and unresponsive to conservative management.
Platelet Rich Plasma (PRP) injection treatment with Dynamic Osteopaths
Blood consists of Red Blood Cells, White Blood Cells, Plasma, and Blood Platelets. Platelets are known to be responsible for blood clotting and releasing growth factors. It is these Growth factors, released from platelets upon activation, influence the biological processes necessary for the repair of soft tissues, such as tendon or ligaments, following acute traumatic or overuse injuries, Like planter fasciitis.
Recover Platelet Rich Plasma (PRP) offers a promising natural treatment to accelerate the healing of tendon injuries. PRP prepared with us here at Dynamic Osteopaths is blood plasma with concentrated platelets and white blood cells containing huge reservoirs of bioactive proteins, like the important growth factors. PRP injection therapy offers a technique to accelerate the healing of a plantar fasciitis.
Here at Dynamic Osteopaths in Solihull regularly treat planter fasciitis with very successful outcomes. The major advantage is that the treatment is completely natural.
Planter fasciitis treatments and platelet rich plasma PRP
A 20ml sample of blood is withdrawn from your arm. The blood is then transferred in a unique tube that is placed into a centrifuge that spins the blood for up to 10 minutes. The centrifuge step removes all ‘unwanted components’ of blood that are not primarily responsible for healing. After centrifugation the PRP is collected. PRP (containing platelets, growth factors and white blood cells) is ready to be injected back into the tendon at the site of the chronic injury, being the planter fasciitis in this case.
Before injecting the PRP
After just one single skin poke, the PRP will be injected into The affected tendon, bathing the tendon with the bioactive cells it needs.
After treatment
Immediately after the injection you are advised to take it easy. Afterwards you can go home and carry out relative rest for the next 24 hours. Anti-inflammatory drugs are not allowed. Icing can be a good solution, if required.
Slight understandable discomfort associated with an injection at the site of injury may result for A few days following the PRP injection. It is expected to feel some discomfort a few days after, as we want a pro-inflammatory response which is a good thing to kickstart the healing process.
A few days following your treatment you will have to start a standardised stretching protocol (level 1, see exercise protocol) to follow for 1/2 weeks.
After the 1 week of stretching a formal strengthening program (level 2) will be added. Gradual return to activities is allowed after 3 weeks. Patients are advised that up to 6 weeks may pass before a benefit is fully established with Normal functional activities. but patients often note decreased pain after as little as 3 weeks.
Plantar Fascia Stretching Exercise (Level 1)
You should perform the stretches in this section daily for 2 weeks. When the pain caused by your Plantar Fascia is becoming less, proceed to Level 2.
Passive Seated Plantar Fascia Stretching
Purpose: To passively stretch the Plantar Fascia.
Start Position: Seated with leg fully extended. Loop a towel/band around your foot.
Action: Slowly and gently pull the towel/band toward your chest. This will stretch your Achilles tendon.
Parameters: Hold the stretch for 20 seconds and repeat 10 times.
Tips: Keep your knee fully extended and make sure to do the stretch slowly. Do not stretch into any signifiant pain.
Purpose: To gain exibility in the muscles that run along the back of your lower leg.
Start Position: Lean against the wall with the leg to be stretched behind the other. Disperse weight of back leg on the ball of the foot.
Action: Shift your body weight toward the wall and gently press back heel to the oor. Perform exercise with back knee completely straight.
Parameters: Hold stretch for 20 seconds. Repeat 10 times.
Tips: Keep back heel on the ground during the 20 second stretch; the movement for this stretch is subtle.
Plantar Fascia Strengthening Exercise (Level 2)
The exercises in this section should be done every other day for 2–4 weeks after completion of Level 1 Stretching.
Heel Raises Strengthening Exercise
Purpose: To strengthen the muscles along the back of the lower leg/ankle.
Start Position: Stand with feet at on the oor and hands against a wall.
Action: While keeping the balls of the feet on the ground, lift both heels off the oor.
Parameters: Repeat for 3 sets of 25–30 repetitions.
Tips: Lower the weight back to the oor very slowly in comparison to the rate in which you raise it (1 second up, 3 seconds down); distribute the weight evenly between the rst and fth toe throughout the exercise.
Purpose: To strengthen the muscles along the back of the lower leg/ankle.
Start Position: Stand on the leg to be exercised next to the wall.
Action: While keeping the ball of the foot on the ground, lift your heel off the oor
Parameters: Repeat for 3 sets of 25–30 repetitions.
Tips: Lower the weight back to the oor very slowly in comparison to the rate in which you raise it (1 second up, 3 seconds down); distribute the weight evenly between the rst and fth toe throughout the exercise.
Optimal treatment for your Plantar Fasciitis
The combination of the PRP procedure here with Dynamic Osteopaths together with the Stretching and Strengthening rehabilitation program afterwards may provide you with the optimal treatment aiming to restore your plantar fasciitis into a healthy plantar fascia tendon without pain. When treatment is successful you may be able to return to all activities you were restrained from due to your plantar fasciitis.