We all know the British summer is here when people start to shed items of clothing piece by piece and our feet come out of hibernation from our comfortable boots into the delights of the summer shoe wardrobe. So as you slip on your cool, airy flip flops and prepare for a balmy summer evening– here are some pointers to help you prevent one of the most painful and common foot conditions. It’s a problem that can affect people of any age, sex or shape with any activity level and it can stop you in your tracks and even affect your first step as you get out of bed in a morning, and if you’re really unlucky you can get it in both feet!
Firstly what is it that affects an estimated 10% of us in a lifetime? It goes by the medical name plantar fasciitis or plantar fasciosis and is also known as policeman’s or postman’s heel. The plantar fascia is a ligament like structure in the arch of the foot that inserts into the underside of the heel bone – and this is where the pain arises. It was originally thought to be an inflammatory condition but unless it is an acute injury it is now thought to be a degenerative –or wear and tear condition, which if left untreated can last years, and even if it clears up can reoccur at anytime. So if you have it or know someone who does – hopefully you can learn how to monitor and manage your symptoms to prevent it from returning once we have worked together to resolve your pain!
What does it feel like and how does it start? Well, the heel and arch area can begin to feel stiff, ache or throb after wearing certain footwear or undertaking specific activities, and as it progresses it may be particularly painful on your first steps in a morning and after resting for a period of time. The painful area is caused because of repetitive strain to the area especially caused by long periods of standing and not helped by carrying excessive weight, having tight calf muscles and also by poor mechanics of the foot. (By this I mean excessively low or high arches – your Podiatrist can confirm this for you). In my experience your chances of getting this condition are increased with wearing flat or unsupportive footwear – typically ballet style pumps, plimsoles and flip flops – common favorites of the summer season. I am not saying that these shoes should be avoided 100%, but for you to consider how much activity and walking is done when wearing this footwear and I would recommend that you keep it to a minimum.
If these symptoms begin what can you do? A Podiatrist – the foot expert of the health profession, is a great place to start to discuss the diagnosis, identify potential causes individual to you, and put in place a treatment plan as quickly as possible before the condition becomes chronic. In reality though, most patients visit their GP or turn to Google and purchase various plantar fasciitis ‘not-so-miracle cures’ before doing this!
What treatment can you expect from a Podiatrist for this condition? An accurate and confirmed diagnosis is key to successful treatment as there are other causes that can mimic plantar fasciitis that need ruling out. Diagnosis is made by clinical assessment of symptoms, your foot and your lifestyle and footwear choices. Some extended scope Podiatrists, such as myself, will also use ultrasound imaging to look for characteristics in the appearance of the fascia that occur with this pathology such as increased thickness to identify the location of the problem. Treatment generally consists of exercises, footwear changes, taping or casting, injection therapy, orthotics (insoles) and physical therapies all tailored to the individual patient.
So before you don flip-flops, gladiator sandals or pumps to trek the length of the Trafford Centre or Blackpool Promenade this summer consider that 10% of the population will get this condition, so support your feet well when you are most active. For those who are already familiar with this condition the long-term prognosis is good with appropriate treatment and 80% achieve resolution within 12 months.