Painful heels, especially 1st thing in the morning, are often labelled as plantar fasciitis but did you know that there is more than one type of plantar fasciitis ?
Here is a quick summary of the different stages of plantar fasciitis.
Acute plantar fasciitis - sharp pain in the arch and heel that has lasted less than 6-8 weeks - is usually the result of a one off trauma or overload. Starting a new exercise routine or new job that involves much more standing or walking can often be the cause.
How should you treat it?
In these cases simply ensuring you wear supportive shoes, such as running sneakers, dialing back the amount of sport for a few weeks or just a few weeks of rest can be enough.
But what happens if the foot pain continues?
This is what we call chronic plantar fasciitis and a totally different approach is needed.
At this stage the body has lost its ability to deal with the loads being placed on it and is incapable of healing itself as the initial overload of the plantar fasciitisa leads to tiny tears in the soft tissue.
The body responds by creating scar tissue to heal the tears but these repairs are not as effective at dealing with load as the original tissue, leading to increased stress now being placed on the healthy tissues which in turn become damage. This vicious cycle continues until the foot becomes too weak to cope and chronic pain occurs.
What is the recommended treatment?
The treatment approach in these cases is 2-fold.
Firstly custom orthotics which are used to reduce the load on the plantar fasciitis.
Secondly, a series of weight bearing, strengthening exercises are used to re-educate the foot so that it is capable of handling the day to day forces it experiences with every step.
This combined approach usually results in plantar fasciitis being resolved but it does take up to 6 months normally, and in some cases much longer.