PLANTAR FASCIITIS / FACSIOPATHY

Plantar fasciitis or fasciopathy is an annoying and restrictive foot pain.

 

The plantar fascia is a thin film of connective tissue that runs from the heel to the ball of the foot. Imagine a layer of cling wrap between the skin of your arch and the muscles under your foot bones. It supports the arch of the foot and helps with the mechanics of foot movement.

 

Pain is often sharp on weight bearing, usually close to the heel. Commonly worse in the first few steps in the morning or after prolonged sitting.

 

TREATMENT:

 

Physiotherapy has been shown to be effective (Hasegawa et al, 2020).

 

Good physiotherapy treatment should involve careful assessment of the foot.

 

In my experience disfunction in foot mechanics are frequently involved. Stiffness in the important joints of the foot can lead to extra load on the fascia and subsequent injury. Manual mobilisation (loosening) of any stiff joints often gives rapid improvement by easing the burden on the fascia. It is wonderful when a client says they can walk again!!

 

Taping can be helpful. Advice on stretching of foot and calf muscles and strengthening is of value.

 

Orthotics and footwear should be considered in some cases.


References: 

 

Hasegawa, M., Urits, I., Orhurhu, V. et al. Current Concepts of Minimally Invasive Treatment Options for Plantar Fasciitis: a Comprehensive Review. Curr Pain Headache Rep 24, 55 (2020). https://doi.org/10.1007/s11916-020-00883-7

SIDE HIP PAIN

July 1, 2025
Pain on the side of the hip from bursitis or gluteal tendon inflammation is an annoying problem often more so at night because lying on it frequently disturbs people’s sleep. It is a reasonably common problem for me to see. Tendons and bursae degenerate as we age and weakness in hip musculature can be a cause. But it can happen to anyone. Guided steroid injections can help, but most people respond well to soft tissue manipulation. The lower back should definitely be assessed and (usually) treated manually as related spinal joint stiffness frequently contributes to the issue. The hip joint should also be assessed and treated if necessary. Exercises can be helpful but need to match the pathology so an Ultrasound image might be needed give a diagnosis.

IRONMAN

June 1, 2025
Interstate visitor Client D came in two days before the Melbourne Ironman. Despite treatment interstate he had persisting leg soreness which had stopped him running for a week and had serious doubts on finishing, let alone doing well enough to earn him what he entered for: a qualifying position in the Hawaiian Ironman. He had some back joint stiffness and lateral hamstring trigger point muscle spasm and after loosening these up he felt better. However running a full marathon after the 3.8 kilometre swim and 180 kilometre cycle would be a massive test! The news post race was that he had got though the event and even with a puncture on the cycle grabbed a spot in Hawaii!  Well done to him! (And a bit to me too!)