Plantar Fasciitis is a funny name for a pain that is no joke.

Heel pain is an excruciating condition to suffer from and Plantar fasciitis is the most common form of heel that there is. Most patients we see have never heard of it until they get it and then do some research on the internet. The problem with self diagnosis is that like on most subjects the net is full of misinformation. Hopefully this article will help clear up a few things.

Plantar fasciitis is an inflammation of the plantar fascia, a ligament-like structure under the arch of the foot that goes from the big toe joint to the heel bone. The most common version is a pain at the attachment point of the structure just at the inside/front portion of the heel bone.

The pain in the heel in the morning can be the most painful it will be throughout the day.  This is due to the fascia ‘resting’ and tightening at night.

Inflammation builds up over years of repetitive ‘pulling’ on the attachment due to incorrect biomechanics. or tightness in the plantar fascia which is strained during activities such as walking and running.

Most people think that their problems started only a few months previously to attended the clinic but in fact their condition started years before but is only starting to ’cause’ pain in recent times.

A few myths about plantar fasciitis

The following don’t cause plantar fasciitis…but they do have an influence on it:

• Bodyweight
• The wrong shoes
• The wrong running shoes
• Trauma (such as jumping down off a high surface)
• Heel spurs…more on this later

Being overweight doesn’t help your biomechanics but carrying excess weight doesn’t cause heel pain, it just adds to it.

Incorrect footwear choices will increase pain because of lack of support for the ‘badly positioned’ foot. However, they don’t induce heel pain. Avoid slippers, slip-on shoes and shoes with little stiffening in the heel area such as deck shoes.

Heel spurs are an interesting problem. This is because you can have heel spurs and never get heel pain and vice versa. They can cause heel pain but a lot of the time this is just a traumatic pain and not actual plantar fasciitis. Claims that all plantar fasciitis pain is caused by heel spurs are just false.

Treatments for plantar fasciitis

Treatment can be very simple to apply.

The main form of treatment we apply at Leinster Clinic Biomechanics Lab are foot orthotics. We also recommend a stretching programme and sometimes a night splint. The latter 2 are pain management treatments. Altering your biomechanics, the main cause of the pain, is the primary treatment because if we don’t solve the reason for the heel pain then the other treatments aren’t going to be successful at all.

Sufferers of plantar fasciitis can be helped easily in most cases but the misinformation and maltreatment of this condition is rampant and continues unchallenged in many corners.

I was a little flippant in my last post but there was a good clear message behind it.  That message is…Flip-flops and sandals are bad for your feet.  I hope I’ve been clear…   They may feel good as they keep your feet aired during hot times but they have a severe lack of foot support.

These are my top five reasons why, from a biomechanics point of view, why sandals and flip-flops are bad for your feet:

1.  Walking in flip-flops (and to a lesser extent sandals) causes you to take shorter strides so you take more steps than normal leading to an increase in pressures and forces on the body over a similar distance walk compared to a normal shoe or runner/trainer.

2.  When you walk in flip-flops and sandals you have to scrunch your toes up to aid in keeping the flip-flop or sandal on your feet.  This leads to shortening of the toe tendons which over a period of time can contribute to alsorts of toe problems

3.  Flip-flops and sandals provide zero ankle support whatsoever and this can lead to contributing to a range of foot and ankle biomechanical issues.

4.  When there is no ankle support in a shoe the arch has to over work.  This can contribute to a range of foot and ankle biomechanical issues as well.

5.  When the above problems occur you increase the pressures on the knuckles of the ball of the foot and they can become sore.  They are taking pressure in a way that increases pain in those knuckles leading to a probloem known as metatarslagis….which just means pain in the ball of the foot.

As an added bonus….in Ireland you are going to get wet too……

I haven’t even started to go into the reasons why flip-flops are bad for your knees, hips and back.  I don’t want to come across like a school headmaster so we’ll leave that lecture for another time.

Just try moderating your time in flip-flops and sandals and try to make those occasions when you’re not doing too much activity.

Sorry?

“Can I wear them with my flip-flops and sandals?”

Ehhh……no.

Controlling foot motion is a complicated business. This shows by the way I have just assessed your biomechanics, designed your foot orthotics, cast you in the optimum position, advised you on wearing suitable footwear and taken 4 years of University and 12 years of working with some of the big names in feet (sorry!)……….and so on.

What do you think?

Next time we’ll discuss why.  Just have a think about it for a few minutes.

David
(A serious message …. but with tongue in cheek)

footorthotics.ie is the home of The Leinster Clinic Biomechanics Lab based in Maynooth, Ireland. We are Ireland’s leading foot and ankle biomechanics lab and we specialize in helping people with heel pain, foot pain, walking injuries, running injuries and knee pain through custom foot orthotic therapy.

As well as information on how to contact the clinic you will also find informative articles and posts in this journal.

Thank you for reading,

David Kingston
B.Sc.(Hons) Orth