What is Plantar Fasciitis?
Plantar fasciitis (PF) is the most common foot condition treated by health care providers. This painful condition can cause impairment of activity and disability. In the United States, about 2 million people are treated annually for this foot condition. Patients usually report pain after palpation of the proximal insertion of the plantar fascia and plantar medial heel, and the pain is most noticeable when patients begin walking after a period of inactivity. Clinicians have used many approaches for treating pain and improving the function.
Case Study of 44 year old patient with Planter heel pain
A 44-year-old patient reported heel pain for approximately 1 year before treatment. The patient reported plantar heel pain and tenderness at the calcaneal tuberosity. The pain was most noticeable in the morning but was reduced after a 30-minute walk. A diagnosis of plantar fasciitis was made at the initial assessment.
He had gone to a doctor first who gave some anti-inflammatory and advised him to take rest, however; there was no difference in the pain after he had stopped taking the medicines. Afterwards he started with physiotherapy sessions which on questioning, had consisted of calf stretches and ultrasound over a 6-week period. He had also tried orthotics in her shoes provided by a podiatrist. But the intervention could not have long term success.
Findings on Examination
In my opinion, the Planter fascia had been overloaded in the past with a number of contributing factors:
After analysing the contributing factors to Planter Fascia, it was concluded to aim initial treatments at reducing pain and off- loading the sore tissue.
I introduced a home exercise programme at this stage, which included no more than 3 key exercises.
We kept a record on a simple spread sheet. Over the course of the next 4 weeks, we re-assessed progress every 1 week. We were generally able to increase the load of the exercises at each session and very gradually increase the walking distance.
Outcome of Therapy
At the end of the 8th week period, his pain levels had reduced considerably-mostly 0/10 and occasionally 1/10 with one measure 2/10 after an unusually long day standing. He was delighted with the results. He was discharged but with a maintenance exercise programme to be continued x 5 per week. (The maintenance is important so that the changes we have achieved in strength gains etc. remain and continue beyond the time of discharge.
A chronic problem necessitates time to be treated and on the part of physiotherapist, it requires hard work to implement the therapy. I suggested to the patient that he should self-monitor the pain levels at 2 key points in the day using a VAS 1-10 scale; morning and at the end of the day, after sitting down. These would act as improvement indicators. Pain levels should remain under VAS of 3 at the 2 points in time. If it would increase, he would just back off standing for a long time.
The combination of hip strengthening and manual therapy improved foot pain in a patient with a clinical diagnosis of plantar fasciitis.
Come to our Physiotherapy clinic in Niti Bagh, Delhi for a chat with one of our expert physiotherapist to plan the right Physiotherapy treatment for you to get rid of pain in no time.