Plantar Fasciitis : THE TRUTH. No Silly Instant Fix Claims !
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- เผยแพร่เมื่อ 5 ม.ค. 2022
- Plantar heel pain (also known as plantar fasciitis or plantar faciopathy) is an overuse condition of the foot which causes degeneration of the plantar fascia at the point of insertion into the heel bone (calcaneus). The common symptom is local heel pain which is worse when standing/walking/running and also first thing in the morning. This video provides evidence based advice and information about plantar heel pain and answers the 3 most common questions asked by people who have been diagnosed with these condition :-
1) What is it ?
2) Why do I have it ?
3) What can I do about it ?
If you found my videos or website articles helpful and would like to buy me a coffee then you can do so by clicking the link below. Thanks very much 🙏🏼
www.buymeacoffee.com/physiomsk
The evidence based treatments discussed have the following time stamps :-
Self Help Treatments :-
1) Managing Load : 7 mins 40
2) Optimising Footwear : 9 mins 17
3) Taping : 9 mins 40
4) Supportive Insoles : 10 min 08
5) Exercise & Stretches : 11 mins 25
6) Night Splints : 12 mins 38
7) Immobilisation Boot : 13 mins 35
Treatments provided by Clinicians :-
1) Cortisone Injection : 15 mins 15
2) Shock Wave Therapy : 16 mins 38
3) Dry Needling : 17 mins 32
4) PRP : 18 mins 10
5) Surgery : 18 mins 50
The insoles / orthotics & other products mentioned in the video can be found below.
The channel uses affiliate links for certain products that may be shown in the videos. When you use one of these links to purchase a product, the channel receives a small commission at no extra cost to yourself. This helps support the running costs of the channel and website www.physiomsk.com
1) Blue spot gel heel insoles : amzn.to/3qPiB4G
2) Arch support insoles : amzn.to/3Lv8NGx
3) Arch support + pressure relief insoles : amzn.to/3BU3ey8
4) Night splint 1 : amzn.to/3QW4dCs
5) Night splint 2 : amzn.to/3UmTUu2
6) Immobilisation boot : amzn.to/3xCVwGp
7) Zinc oxide tape for the low dye taping technique : amzn.to/3SjUwyy
Links to other videos mentioned can be found here:-
1) Introduction to my channel • Introduction to my Cha...
2) 3 of the best stitches and exercises for plantar heel pain • Plantar Fasciitis | 3 ...
3) How to tape your own plantar fascia • Tape your own Plantar ...
Some of the images used in the video may belong to their respective copyright owners and neither I nor this channel claims any right over them. Their use has been considered appropriate for fair use policy under Copyright Disclaimer section 107 of the Copyright Act of 1976. Allowance is made for “fair use” for purposes such as criticism, comment, news reporting, teaching, scholarship, education and research. Fair use is a use permitted by copyright statute that might otherwise be infringing.
The podiatry picture is from westrydepodiatry.com.au/orthot...
Disclaimer
These videos provide general information related to various medical conditions and their treatment. They are intended for informational purposes only and are not a substitute for professional advice, diagnosis or treatment provided by a doctor or other qualified health care professional. The information provided does not constitute personal advice or guarantee of outcome and should not be used to diagnose yourself or others. You should never ignore advice provided by a health care professional because of something you have seen or read on this channel. You should always consult a doctor or other qualified health care professional for personal medical advice.
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This is the best discussion of Plantar Fasciitis I have yet seen, and I have watched hours of them. Interestingly, none of the others have talked about load management, which intuitively seems obvious. Thank you for this excellent video!
Thanks v much for the feedback Annie. Yep load management is the single most important factor. It should be bolded and underlined !! I wish you all the best with your recovery.
Stephen.
How can i talk to Dr.
Iasm strugglin with PF
I
@@PhysioMSK😊
This is the most valuable info I ve heard👍
I’ve had this condition for 6 months now and I’ve seen many videos about it but this is the clearest explanation of what it is and also the most honest about what can be done to treat it and what to expect in terms of healing. Thanks so much Steven!
You’re very welcome Laura. Good luck with it !
Brilliant !!! This is first video that ever seen that makes sense.
Thanks for letting me know . I’m glad it was helpful. Much appreciated. Stephen.
Life of a teacher 😩. Definitely overloaded .
Yep 🤷♂️
Thank you for this very useful and detailed information in understanding of this issue. I feel a lot better through this education. Very much appreciated...
You're very welcome!
Excellent! Thank you.
Thank you for this video and the one about exercises and stretches. I am just beginning to explore treatment options for plantar heel pain. In looking through TH-cam videos and websites I am finding that there is a wide range of often contradictory treatments and options from people claiming to be doctors and specialists. So, I was glad to come across your videos that didn't promise overnight cures but instead offered straight talk and practical advice for practical steps that an individual can take to improve their chances for successful recovery from this often debilitating condition. Thank you again for your honest straightforward videos.
Many thanks for the feedback. This is exactly the reason why I make this content. To try and cut through the misleading click bait and provide some honest advice based on current knowledge and research. It’s nice to know it’s appreciated. Thanks again.
Having suffered with PF for two years now and having tried pretty much everything and watched hundreds of videos, I found your presentation absolutely brilliant! Calmly explained and encompassing all angles. It was a good reminder that I need to go back to basics and reduce the load, because although I gave up aerobics and long distance walking at the onset, I think must still be overloading in some way, although the discomfort is not as bad as it was. So thank you for that reminder!
Thanks very much for taking the time to comment Pauline. It can be a frustrating condition but once you understand why it occurred and what your current load capabilities are you can start to make progress. Best of luck. Steve.
I have watched so many videos on this topic and the reason I kept watching more was because none of them were giving me the answers I wanted. So finally here is an explanation which makes sense, clearly and simply presented. Thank you Stephen. Everyone swears by their own cure, but the therapies vary so much and in some cases actually conflict. One says pull the toes back, another press them forward. My heel pain has gradually disappeared over 8 months trying various things. But seeing this video, it makes sense that the most important thing I did was reduce the load. In my case running fewer miles, and changing from heel running to forefoot "pigeon toed" running. My pain began after running a half marathon. An x-ray revealed a heel spur but explained nothing. Obviously the spur did not just appear overnight. And I'm sure it is still there, even though the pain is almost gone. Nothing made sense about this injury. Why was the pain worst in the morning when the foot was completely rested? Another question I still have is whether the plantar fascia has its own nerves, or whether there is a bundle of nerves between the heel and the plantar facia, or both?
Hi Vincent. Thanks v much for the feedback. Indeed load management is the single most important factor in managing this condition but it is rarely discussed properly in most of the self help guides. Unfortunately I didn’t have the time to discuss heel spurs and running styles in this video but I have a addressed them on my website here www.physiomsk.com/2022/01/plantar-heel-pain-plantar-fasciitis.html?m=1
About your nerve question, yes the plantar fascia has its own nerve supply (or it would not been capable of generating pain) but these nerves don’t usually get squashed or irritated. Other local nerves can do though, and if you have additional symptoms of pins and needles then it might be worth considering Baxter’s neuropathy or tarsal tunnel syndrome as an alternative or additional diagnosis.
Best wishes
Stephen.
@@PhysioMSK Wonderful, thank you. It seems that the heel pain is a very late indicator of the problem. The overwork probably caused the bone spur in the first place. And I remembered back, six months before the half marathon, when I started using barefoot shoes. I experienced sharp pain if I ran over small stones. At the time I just blamed it on the lack of cushioning in the shoes. But it was an early warning that there was a problem.
Brilliant, I understand now what is going on….thanks so much
You’re very welcome.
Thanks you very much for the good idea please help me to get rid of this problem on my heel pain
I've watched probably 60 videos from medical doctors and physical therapists and this advice is the most logical and seems to match my own experience and what has worked with my own pretty bad case of plantar fasciitis.
Thanks for the feedback Greg. Much appreciated. The reason I do these videos is because I’m fed up with all the poor quality click bait videos out there. I m glad you found it helpful.
Thank you.
This is definitely the best dicussion. Thank you
Glad you think so!
Thank you so much for you clear and thoughtful explanation of PF and the exercises and stretches to address the issue. I also have bunions on both feet and believe they are contributing to the heel pain. Can you make a video about stretches and execises to address bunion issue? They might not correct the existing deformity but perhaps help to stop progressing it? Thank you!
Thanks Larissa. I’m glad you found it helpful. I will add bunion exercises to the list.
Thank you for posting this helpful video, Stephen. I've watched dozens of others. Some saying do certain things, others say don't.. Very confusing and then I find you! My GP is sending me for an xray on Monday to see what's going on with my heel pain, which is getting worse every week. I did read somewhere that an xray is no good for diagnosing PF, is that correct?
Thanks for the lovely feedback Tracy. Much appreciated. X-Rays can be helpful to exclude other causes of pain but they can’t diagnose PF. It might show a heel spur which is a calcification of the PF insertion but that’s just an incidental finding and doesn’t affect its treatment. There is more info about this on my website www.physiomsk.com/2022/01/plantar-heel-pain-plantar-fasciitis.html?m=1
Thanks very much for taking the time to reply Stephen! @@PhysioMSK And thanks so much for the link.
Thank you so much for this. I have been dealing with PF for going on 2 years now. It has not responded to anything I have tried - stretching, recovery shoes, ultrasound, PRP injections, Cortisone injections... nothing has worked. I appreciate your calm & knowledgable communication. Taping is the only short-term solution to my pain.
*By 'ultrasound' i meant shock wave therapy. It was very painful & after 6 weeks of treatment, my foot felt amazing. But that only lasted for 1 day - the PF symptoms returned with a vengeance. The PRP was ultrasound guided (like the cortisone injections) and was just as ineffective as the cortisone. To be honest, the only thing that seems to help is taping.
It’s certainly a frustration condition. Having seen many people with this problem over the years I strongly believe that load management is the key. If you really can’t rest from too much weight bearing activity then I would try an immobilisation boot. Wearing one whenever you walk for 6-12 weeks can really help. I know it seems like a drastic step but it’s worth it IMO. Beyond that, if your symptoms are really affecting your quality of life then it might be worth seeking out and foot surgeon with a special interest in plantar heel pain. Good luck with it.
Excellent video! I’ve been struggling with feet pain for years and just recently decided to see a podiatrist. It turns out I have PF. My physician prescribed me an anti-inflammatory medication and he tapped wrapped my foot. The result was almost immediate. I have almost no pain on the tapped foot and I can hardly believe it. Your video made it all make sense to me. Do you have a video on the tapping technique? I must learn how to do this! Thanks😊
I’m glad you find it helpful. Yes I’ve done a taping video. It’s here. th-cam.com/video/V5hFp---T1U/w-d-xo.htmlsi=5JCOGYizlz8lewkx
Thanks for your enlightening video. I’ve been struggling with heel pain for 7 months, recently had X-ray and MRI, the diagnosis being plantar denervation and heel bone marrow edema. The therapy suggested is anti inflammatories and hyperbaric oxygen treatment. Would all these be caused by untreated plantar fasciitis?
Yes this could be caused by chronic plantar heel pain. Bone oedema is a warning sign that you are still overloading the foot and PF. I agree with the suggested treatment but would also suggest an immobilisation boot for a least 6 weeks in order to offload the PF as much as possible.
@@PhysioMSK thanks for your prompt reply.
Thank you for the information, I have had PF for over 2 years. I have spent a fortune on doctors, shots, splints, boots, inserts, chiropractor Graston, shoes….. now I have back problems from not walking correctly. My new Foot and Ankle Surgeon (athletes fly in to see him) said most of the advice given is just doing more damage. He just cast me for custom orthotics $$$$ and if this doesn’t work the next step will be surgery. I have had trouble walking for over 2 years, I love my feet but am so disappointed with the right one!! Good luck to all with this excruciating pain.
Yep. This is a common story. I do hope you find something that helps but take some reassurance that it usually always burns itself out eventually.
I had heel surgery at age 19, when I was only 119lbs. I’ve had varying degrees of heel pain ever since (for over 25 years). My podiatrist cut very deeply (more than 2”) and explained that he nicked a nerve. I only have the heel pain in my left heel. I find that it helps to use a callous remover and stretch, as you describe. I love wearing high heel sandals that fit me well. Supportive platform styles work best for me. I’m in my 40s now and it’s definitely gotten worse in recent years. I’m overweight which is a factor but I also had the same heel pain in my 30s when I was a healthy weight. Wearing flats is extremely uncomfortable and even painful for me. I have very high arches. I love wearing flip flops but I can’t walk very far in them. The tape method seems awkward. I do use supportive insoles! I probably would benefit from a custom insole for high arches.
Hi. This doesn’t sound like typical plantar fasciitis to me. It has going on for way too long and there has been surgical complications. I would suggest getting some imaging, preferably MRI or an ultrasound + X-Ray. This is not typical plantar heel pain.
This is a very good video. I had a year long pain in the arch of my foot which was diagnosed firstly as plantar fasciitis but later changed to flexor hallucis longus tendon issue. Either way, I was sent to do 5 sessions of ESWT and it completely resolved my issue when nothing else could.
I’m glad it got better - whatever it was !
I have this in both feet by standing for too long and walking on hard floors. Under the complete feet, not only at the base under the verse. As soon as I put my feet on the floor, it starts. This has been the case for a good four months. And I relieve wherever possible. . Do stretching exercises that do not increase the pain too much on the same day and the day after. Strengthening exercises, especially the so praised Heel Raise, have always thrown me back, so also for three weeks. Now I realise that in the days before the circumstances, there was also a lot more pain reduced from walking. I will do her tip exercises for strengthening only when the pain is much better when being on the feet. I've been getting night rails and Strasbourg socks for a long time. At night I wear the socks, but I have to be careful that I actually pull them up more than one finger width on the toes, otherwise this has a negative effect on pain. I wanted to put on the night rails by the hour during the day to relieve the feet. Does that make sense? Greetings from Germany, Thomas.
Yes that makes sense. Unfortunately It is a frustrating condition that takes a long time to get better. The best advice I can give is to carefully follow the information on the video and the website here www.physiomsk.com/2022/01/plantar-heel-pain-plantar-fasciitis.html?m=1
Good luck 🤞
@@PhysioMSK
Thank you for your quick response and recovery wishes .
Yes, that gnaws at the quality of life. I have translated the linked article into German and will first be as little on my aching legs as necessary. After the relapse two weeks ago, I can first estimate how relatively far I was actually already for my circumstances, which is why I will only do the exercises that put me on the right track. And that wasn't very much and there was no stretching of the plantar tendon because I'm wearing the Strasbourg socks overnight. And in between again and again my feet out of the shoes and from the floor to relieve. Regards, Thomas.
Would Treatment for bruised heal be similar in your opinion??
A simple bruised heel should be caused by a blunt trauma eg. Fall from height and be better in a few weeks. If it’s not better after 6 weeks then it’s probably plantar fasciitis now.
Hello, I also have PF. And my doctor recommended me extra corporeal shock wave therapy which I haven’t started yet. As I’m afraid and doubtful of it. My MRI showed that I have heel spur too. I do some exercises but the pain persists for now. Don’t know what should I really do now
There is more information about this condition on my website here www.physiomsk.com/2022/01/plantar-heel-pain-plantar-fasciitis.html?m=1
I’ve heard mixed opinions among experts on shoe wear, there’s a couple saying that minimal shoes actually are better for healing. Others say cushioning is good. What is your opinion on this? Thank you.
I think cushioning is needed when the condition is severe and irritable. If it’s low irritability then reducing the cushioning in order to make the PF more resilient makes sense. So it really depends on where along the healing process it is. The research is more supportive of cushioning though.
30 yr old F - I’ve had classic planter fascia symptoms mentioned in this video for over twelve months which i was getting under control. Then 8 weeks ago it really flared up again in both feet. While it’s calmed down, I’ve developed a random pain at the very back of the heel fat pad (ie not where the initial planter pain point was) which feels like walking on bone. It’s not worse first thing in the morning, it hurts anytime I stand on it. Podiatrist has no idea why that would have started randomly. Any thoughts ?
I would want an ultrasound scan of the region. It could be heel pad inflammation or insertional Achilles pain. Could also be a Baxter’s nerve irritation.
@@PhysioMSK thanks for replying - ultra sounds and x ray of both feet showed nothing unusual except minor fluid at the calcaneal bursitis only on one side. Nothing else. I tried a two week course of anti inflammatory meds as well, no relief. The only relief is either not putting any weight on my feet, or wearing the most thick padded shoes (like recovery crocs). I do find the pain lesser temporarily if I massage planter / back of leg regions. Not sure what else it could be - going on 9 weeks of this weird heel bruise type /marble under the skin / walking on the bone pain right in the centre back part of the heel pad on both sides
Even a small amount of fluid in the calcaneal bursa can be very painful. You’ve probably developed an insertional Achilles irritation. If it’s bad then using an immobilisation boot should help. Using prescription strength anti inflammatory gel can help and Injecting the bursa could also be considered.
What do you think of acupuncture?
Just putting needles in and leaving them is unlikely to help. Needle fenestration (acupuncture needles can be used) into the plantar fascia can be an effective treatment. Personally I use local anaesthesia and an injection needle to do this though as it can be painful otherwise.
How about PRP ?
I discuss this in the video. At 18 mins.
What is your opinion on Low-Dose Radiation Therapy? Is it also a provocative option like shockwave, and could it be effective?
It looks like a promising treatment option but the evidence is very limited at the moment. More studies are needed before we have a better idea of it’s effectiveness. Certainly one to watch 🤞
I fell down the steps and ever since then I've been struggling with this exact thing for like 2 months. :(
As long as you don’t have many of the risk factors mentioned, the ones I see after trauma like this generally get better more quickly. I’m keeping my fingers crossed for you 🤞
Do these exercises help with haglund deformity?
The mid range exercises can help but not the stretches. Stretches just compress the Achilles tendon against the Haglunds and irritate it.
@@PhysioMSK
So by mid range you mean the exercises where you go up on your toes (work on the calf) not any that forces toes back which tightens the Achilles against the HD. Right?
Yes. I would do that exercise but I wouldn’t take it to the end range stretch position where the Achilles tightens (end range ankle dorsiflexion). Therefore I would do the exercise on a flat surface, not with toes on a step. I might also do a single leg balance exercise, aiming for 30 seconds balancing on 1 foot.
I got it two days ago after wearing heels one whole day. Hopefully it will go away
If it’s only 2 days then I would expect it to settle down fully within a few weeks. Heels are evil ! 😂
What about dressy work shoes???
Do they hurt when you wear them, compared to other shoes ?
I was actually wondering if there was a recommendation for a good dress flat that would work well with this...
@@jennybaker5713 oh ok. I’m not sure sorry. But if you use an insole or heel cushion with them then I’m sure that most flats would be fine.
@@jennybaker5713 Vionics have tons of dress shoes 😊.
How about laser therapy?
There is no good evidence for laser therapy. As this was a review of treatments supported by research I had to leave it out, along with many other ‘treatments’.
@@PhysioMSK I did laser therapy on my heel and neuroma. It works after 6 sessions but the pain came back because I didn't wear good footwear. Otherwise it does work.
👍👍🇺🇸
38 year old skateboarder.
WokeyWokeeey !!!! No mention of reducing weight then?????? Overweight must surely be a prime aggravating factor !!!
It can be yes, for some people but certainly not always. Also weight loss is a slow process and this video is aimed at treatments which are likely to improve symptoms as quickly as possible for everyone. I have gone into more detail about PTTD on my website which includes info about the benefits of weight loss :-www.physiomsk.com/2023/05/posterior-tibial-tendon-dysfunction-pttd.html