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.
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!
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.
I first developed PF about 6 years ago. After exercises and wearing arch support insoles it went away after about 2 years. This year it’s just come back - but I kind of put that down to not wearing supportive shoes during the summer months. Back to sensible shoes for me now. This is very informative, but I have a primarily sedentary lifestyle and I need to walk to places for regular exercise. Most effective short term relief has been the foot massager I recently bought. Found a really good one on Amazon for about £120 and it’s changed everything over the last couple of months. Properly kneads along the soles, and I find 30 minutes of use a day makes a lot of difference.
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.
I think you are the only person who says that the heel pain occurs throughout the day and is worse after sitting for a while. Most ‘experts’ say that the pain occurs first thing in the morning as you step out of bed. I woke up yesterday morning with it 😡. I’ve had it before so I know it’s a long process to get back to normal. Thank you for taking the time to make this video. I’ll be checking out your exercise videos.
If one is sitting for a long periods of time, wouldn't it have the same issue as when in bed for 6 to 8 hours? The fascia has then shortened so, it would stand to reason that it would then be painful when one gets up? I have a wooden roller to gently exercise my foot without weight on it and its very nice just having my foot on it. Its curved so supports the arch of the foot. This lessens the pain to non existent when I do have to get up and walk - eg to simply go get a coffee/food etc. At night I am wearing a arch support around the foot which has definitely helped. Last night I didn't....and its more painful this morning. So, will ensure I wear it at night.
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.
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.
To all people with PF, check if you maybe have functional hallux limites. This will interfer with your windless mechanism and will put a lot of stress on your plantar fascia. See if your podotherapist can mobilise your big toe again. This could solve your PF.
Thank you for this very informative video! Your video is the first one I’ve watched that clearly describes the plantar fascia, the makeup of it and the thickening of it from the damaged fibers. Also you’re explaining the treatments step by step is the only explanation I have seen outside of my doctors office. I had several cortisone shots and all of them lasted 3-5 weeks, then the pain returned just as you described. I’ve stopped receiving them and have since been taking a collagen supplement and each morning before stepping out of bed, I slowly place weight on my foot and stretch out my calf muscles before walking. This has helped me a lot but I still have the pain at times. Some days are great and some mornings are better but I think my work still aggravates it. I’m a year and a half so far dealing with this, I hope it gets better soon. Thank you for your information.
I could cry!! I’ve had PF for 6mths and it’s getting worse!! I’m having shockwave treatment atm…second treatment this week. That’s extremely painful though, I’m not looking forward to getting it done again. Just hoping it helps. I’ve tried stretches, iced bottle on foot, resting, hot water bottle, toes spreader, in soles, ball 🥎 on arch… I think running and flip flops were the cause. I’m not over weight. I’m in the age range of getting it though, aged 50. It’s soooo frustrating. Getting it on my right foot now a little as well as my left. I had PF in 2019. It took 5mths to go. Good luck to anyone suffering…I know how you feel!!! 💔😭😭😭
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😊
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.
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...
I tried all of the exercises in every TH-cam video. Only going to the podiatrist and getting injections in my feet helped. Then wearing cushion shoes every time I stood up.
Thanks for sharing. I’m glad it helped. Yes I am doing more injections recently. I do them ultrasound guidance and they do seem to work well. The research doesn’t agree though.
What about the heat that I feel on the fascia,is that the inflamation?Amazon worker.....10 hrs on feet per day.See I been doing exercises from physio whilst still inflamed😢 This has been most comprehensive info I've seen up until now.Thanx
Thank you. Looking for answers and have tried so many things. Carrying overload seems to be a factor. Extra weight pressure definitely increases the pain. But it’s hard to avoid. I’m always carrying or lifting something. Have done so many things and my podiatrist said he ran out of suggestions and treatment so viewing other videos like yours. Time, exercise, constant stretches , would like to decrease 10 lbs, inserts, 1/2 size larger shoe, toe separators for period of time, shoes with bigger toe box and more ….. my goodness. Using an elevated chair would be nice when I have to stand for more than 1.5 hr. I do a little dance movement to vary the pressure. Having an elevated chair is an issue for the work environment so thats out. Losing 10 lbs would be an answer but have not been able to make that happen. Gotta keep working at it. Good luck folks. Never give up. Thank you doc for your realistic and informative video.
Your’s is a common story. There is an opinion amongst some clinicians that the wide variety of treatments available just keep the patient entertained while it eventually gets better by itself in the background. Food for thought.
I'm suffering again, one foot only, after years of no symptoms, agony on my heel and I work 4 hour shifts stood up and constantly walking up and down, I took a stool in to work to give me breaks, as i end up hobbling on the side of my foot. I normally live in high ankle type boots, no orthotics needed, wondering whether changing footwear due to seasons plays a part, though my sandals come with arch support. I'm not overweight whatsoever, Ive bought several orthotics and some actually make it worse, especially those that have a pronounced bump in the centre, feels like I'm walking on a marble, and some are far too hard, gel heel cushions hurt, i get more relief with memory foam heel pads which you can pick up at bargain stores in the UK . Im currently using my tens machine and a foot massager to stimulate blood flow, heres hoping it doesnt drag on 😢
Im thinking my gait plays a part , I wear down the outside of heels so maybe under pronation, plantar fasciitis, mortons neuroma in the past and inner knee miniscule tear, all left side.
I find this information very helpful and the doctor speaking very confident and knowledgeable of the symptoms and also the treatment, I used to work as a nurse. I was on my feet for 12 hours a day. Then I had to give up work through an instant at work. In the last 5 years I've taken up my passion for art and during this time I'm usually standing so I can take the point where you say too much standing or exercising can bring on these symptoms of plantar fasciitis. It's given me room for thought on how I can ease the discomfort, I would like to thank you for your informative video on this treatment. Thank you for your help and have a good day 🇬🇧👍🏼
Divorce caused my plantar fasciitis. I am only partly joking. We had two beagles, and they needed to be taken on long walks several times a day. I did the morning and evening walks, and my wife did the two mid-day walks. When she left me, the dogs stayed with me, I was suddenly responsible for all four walks, half an hour each, totalling two hours of brisk walking a day. After just a few weeks of this, I started to experience foot pain, which turned out to be plantar fasciitis. This has been going on for at least six month now. Since my dogs do need their walks several times a day, I can't see much chance of cutting down on the exercise load, unfortunately. I will try using the other fine methods, such as shoe inserts, stretches, and splints, and hope they help.
Great answers to many questions which are actually common sense. Last time I had this was because my doctor said I should start exercising. So I did, and end up injured, took a bit for it to go away. Now, my exercising is my daily workdays but not weight lifting or running but I am still moving alot. And I am on my feet regardless possibly far too much. What I have found from all this is that exercising is harmful and not exercising is harmful. So either way we're all screwed! 👍
That’s a great comment. And you are quite right. Exercising for problems like this is a balancing act. It’s easy to do too much or too little. Thankfully it usually gets better after a few years regardless.
I agree with others commenting that this is the best plantar fasciitis video. I would also like to compliment on the bookshelf ends from the collectors edition of the Lord of the Rings films (I have them as well). After watching this, I do wonder if what I have, as a wannabe runner, is truly plantar fasciitis. The pain tends to be more towards the arch of the foot rather than the heel, and recently it seen to resolve within a day of appearing. Several months ago I had bottom of the foot pain lasting for at least several months it seemed, although never severe, it did keep me from running. In the past, I had been diagnosed with plantar fasciitis, but that was years ago (also from running).
Thanks. I appreciate the feedback. Whilst the vast majority of plantar heel pain is on the inside of the heel, there are variants where the pain is felt on the outside of the heel (the lateral band of the plantar fascia) or in the arch itself. With arch pain it’s also common to get small lumps within the arch called ‘plantar fibroma’ which is a sister condition. These are harmless but can be irritable.
I just had this condition for the first time in my life due to my workplace requiring leather shoes. It comes and goes, but when it comes, it hurts! Buying a synthetic leather shoe (which feels more like sneakers in formal disguise) helped relieve it a lot. Wearing my Fila sneakers also helps. But since this has gone unchecked for months now, it's not really doing much apart from doing some small exercises to gradually strengthen it. It's really disabling.
Catch 22: If being overweight is one of the causes of Plantar heel pain, one needs to exercise to lose weight - but doing so, aggravates the plantar heel pain! I've been trying to increase my exercise by gentle walking, alternating between standing at my rising desk or sitting. Its not a huge amount as I was taking it gently but here I am with the heel pain. I loathe wearing shoes/slippers in the house. So finding something supportive that allows at least my toes to be bare is difficult. I've found some wraps with a gel support in the arch which seems to help and wearing these at night has helped but this seems to be a long journey, Also, not sure the gel support is supportive *enough*. I have extremely high arches and there is still a gap underneath. Lets hope I can get these reversed and healed and find a way to lose weight too. This is a very good video and not sensationalising or dismissing the issues experienced. A question - if the fascia collagen is breaking down, could boosting collagen levels through supplements help?
Hi and thanks the comment. Its a good question but unfortunately eating collagen doesn’t mean your body will grow more healthy collagen.The collagen supplement is broken down in your stomach into its constituent amino acids, the same as any other protein. It then just gets added to the nutrient soup in the intestines and eventually crossed into your blood stream ready to be synthesised into one of many proteins required by the body - including collagen. Good luck with the rehab and weight loss. I know it can be hard but weight loss is mainly achieved through diet - so thats where i would be focusing. Best wishes Stephen
Perhaps look into Finn Comfort sandals. They are very expensive, but have a very supportive, and replaceable, footbed and can take orthotics. They also can be re-soled, so the expense is reduced over long-term use, if you maintain rather than replace. You may already be doing this, but I find that the pain of those first horrible few steps in the morning can be avoided, or at least made manageable, by pausing to sit on the side of your bed, crossing your affected leg, and using the hand on the same side as your PF foot to pull your toes back gently, but firmly, and also gently but firmly use the opposite thumb to massage the plantar fascia. Do this before those first few steps and it will likely make it more comfortable (and maybe over time help the healing go faster because you’re avoiding insult to the injury). Best of luck to you. The journey is very, very long. I know, because I’ve had PF three separate occasions, so it is not overstating to say I’ve had it for years of my life. Fortunately, I lost some weight and have increased my fitness and activity and have not had it in many years, though I’m always on the lookout.
Thank you for the good explanation. I had leg problems for a few months and heel pain for weeks but doctors and pharmacists couldn't & didn’t diagnose it properly. After watching a video on foot taping for PF the other day, I realised my condition. I put tape, did icing, rested my foot and it was much better. Then after watching some "fast cures for PF" videos yesterday, my foot became worse after doing all the stretching exercises shown. I believe it was too early to do them. You are the first Western physiotherapist who has recommended acupuncture. I do home acupuncture for myself and did it on my foot after watching your video. Thank God, it felt much better. I will rest my foot further and do more acupuncture for the next few days. Thank you once again. God bless! ☺️
@@PhysioMSK Dear Sir, I want to report on my progress 😊 After doing acupuncture on my foot yesterday, it is now almost normal and I didn't feel the pain this morning. I was so delighted because i thought i had to rest in bed. But seeing how well my leg had become, I decided to do the day as usual. Just now when I looked at my acupuncture notes, I realised I did do it on my foot but in the WRONG place in February this year. I did it all over the ball of my foot. And the relief was minimal. Yesterday after watching your video & studying your pic where the plantar muscle ended, I did it mostly on that part. And the needles hit the right spot! 😱👏🥳 I hope my new report will help you or someone in future. Thank you once again 🙏 BTW, ironically your video is now an "instant" PF cure for me 🤣
@@PhysioMSK Another progress report ☺️ This might right help those with no acupuncture means. I used the tip of my rounded acu pen about 1/2" in diameter (you can use something similar) to press hard and massage the problem deep tissue points on my sole. You will know which part, from pressing & comparing with your good sole, as there will be a difference. Painful but utterly gratifying.
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 condition is so frustrating, and there is so much contradictory information out there about how to heal it. It just won't go away. Completely disrupted my walking/running routine, which is so annoying!!
I'm going on two years by summer's end. I tried the walking boot but messed up my knee! I have discovered that a low heel is best for me as it seems to pull less on the heel spur.
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!
I got it 3 months ago, i can't even walk without wearing some sort of shoes anymore, so i'm wearing crocs inside. Havent tried any of these methods before so hopefully they work, ive only been using a massage gun. (Doesn't work much)
“opathy” means diseased or having a disease. “Osis” or tendinosis or faciosis is more accurate. Plantar fasciosis is caused by degeneration of the plantar fascia, usually due to chronic stress or repetitive strain. Symptoms are similar to plantar fasciitis, but the pain is not caused by inflammation.
I agree. I've never seen a single case of 'plantar fasciitis' in my career. There is never any inflammation on ultrasound. Its always degenerative. 'osis' is technically correct but never used in this condition. 'opathy' is less correct but still better that 'itis'. All very confusing for patient's which is why I prefer 'plantar heel pain' which is 100% correct - and it de-medicalises the condition which i think is hlepful.
I didnt want to manage my symptoms of akiles tendinitis and plantar fasciatis, I wanted to fix the problem!!! I suffered from these problems for 30 bloody years !!!! In the morning i couldn't simply walk. Currently i started learning about body mobility and it was a LIFE SAVIER!!! SPECIALLY ANKLE AND FOOT MOBILITY. Theres plenty of videos about iton youtube and also streching my knees and hip flexors helped alot . They all conected. I also applied CASTOR OIL PURE, helped my pain go away .. and finally i could bear walking bare foot and bought my pair of bare foot shoes that have been helping alot!!! Currently i have no akiles tendinites nor plantar fasciates. I cure myself !!!
I am having a bad case of Plantar Faschitis, im surprised you didnt mention LLLT /cold laser therapy, which in USA some physical therapists have and NIH data seems to indicate he provides some pain relief, I had some luck with it before but was in consistent w the therapist, im now trying again w a different clinic. Your thoughts? My problem is not from standing its only after resting, driving, sitting, etc...once im standing or walking around im fine, its when i stop.:))
The evidence for cold laser / LLLT is for very short term relief only - which is akin to taking simple pain killers and a waste of money in my opinion. If your pain is mainly at rest then I would question the diagnosis. Have you have inflammatory screening blood tests and/or any form of plantar fascia imaging ?
Cycling is a non weight bearing exercise and so shouldn’t affect the plantar fascia. The exception being lots of ‘out of the saddle’ work which could potentially cause some irritation.
Thanks. There really is no supporting evidence of any quality for prolotherapy, which is essentially just injecting sugar water into someone’s plantar fascia. That’s why it was omitted.
@@PhysioMSK there's lots of evidence for it. here's one article: www.ncbi.nlm.nih.gov/pmc/articles/PMC4938120/#:~:text=Many%20observational%20studies%20were%20of,psychometric%20measures%20reported%20positive%20findings.
I have seen no mention of pain in the ball of the foot. It's like walking on coals after walking a few kilometres (in both expensice running and hiking shoes). Most visuals show the connection at the heel as focus of pain. I meet all other criteria of PF.
Thanks. I have left foot PF. I have a knobbly ball which use on the floor to massage the area forward of my heel. It is painful to do and the facia is quite hard. When I do the same to my right foot it's not painful at all and not hard. I've had this PF issue 6 months now and it's very frustrating as I want to run for my health.
Thanks so much for this helpful information. I was hoping for a fast cure, but now I understand this is a long healing process. In the meantime, I’m vacationing in Turkey for three months and I’m only on my third week. I wonder if I should return home to let my leg heal, or continue sightseeing every other day to allow my foot to rest and recuperate a bit.
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.
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.
This is my first time watching you and your information. I learned more from it than in several years of watching others. I really want to get some insoles, but all your references seems to indiciate they are for people with flat feet. I am looking for an insole for the heel and arch, but that supports a high arch. Are they the same, or is there another one you can recommend. When I click on your links, I am confused by the number of arch supports that are listed.
If you have high arches then you probably just need the pressure relief gel heel inserts. But the arch support Orthotics can also be helpful for high arch feet. They will just take some of the strain off the PF. The problem you might have is knowing how high your arch is and therefore how much arch support you would need. Best option might be to see a podiatrist.
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.
What is the difference between the type of re-injuring created with shockwave therapy and the reinjuring that occurs in the morning when putting weight on fascia that have been in extension all night?
Its a good question. Shock wave is very controlled and targeted and aims to cause 'microtrauma' in order to stimulate a healing response. Morning weight bearing pressure will tend to cause 'macro trauma' which overloads the tissue and causes a much stronger tissue reaction. Its all about getting the balance right of doing too much v too little - and it can be difficult.
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.
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 🤞
@@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.
How long should one wear the insole. I had insoles for 1.5 years, my pain went down approx 80% but got stuck at this point. Wondering if I need a different approach now.
Yes I would say you need a different approach. The insoles are just for pain relief. They don’t cure the problem. I would suggest following the exercise and stretch advice.
I will add my personal anecdote regarding treatments that don’t necessarily work: MLS laser therapy. I just finished a course of 10 laser treatments over 4 weeks (at a total cost of $550, insurance doesn’t cover) and it did nothing what-so-ever to help.
Yeh no evidence for laser therapy at all I’m afraid. Not sure why people ever thought that shining a bright light on any soft tissue would help. Never mind. Lesson learnt.
Ive tried all the stretching and tennis ball but they all made my pain worse, i then tried the “toe squincher” as recommended by jeff Galloway, which really seems to be helping 👍🏻 what are your thoughts on using a TENS machine on heel pain?
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.
Life of a teacher 😩. Definitely overloaded .
Yep 🤷♂️
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😊
That made more sense than anything. Thanks. Will take your advice. John from Braintree
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 !
A very honest account and advice re treatment of this problem. Thankyou very much
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.
Finally someone being honest about this condition and how long it takes to heal if it does thank you so much for sharing this valuable information
You're welcome. Glad it was helpful.
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.
I'm suffering with the same issue. What works for you, can you share please 🙏.
I'm suffering from the same issues. Can you share on some of your tips.
I first developed PF about 6 years ago. After exercises and wearing arch support insoles it went away after about 2 years. This year it’s just come back - but I kind of put that down to not wearing supportive shoes during the summer months. Back to sensible shoes for me now.
This is very informative, but I have a primarily sedentary lifestyle and I need to walk to places for regular exercise. Most effective short term relief has been the foot massager I recently bought. Found a really good one on Amazon for about £120 and it’s changed everything over the last couple of months. Properly kneads along the soles, and I find 30 minutes of use a day makes a lot of difference.
Great video with sensible advice and no silly promises. The only advice that worked for me.
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 think you are the only person who says that the heel pain occurs throughout the day and is worse after sitting for a while. Most ‘experts’ say that the pain occurs first thing in the morning as you step out of bed. I woke up yesterday morning with it 😡. I’ve had it before so I know it’s a long process to get back to normal. Thank you for taking the time to make this video. I’ll be checking out your exercise videos.
Thanks Sharon. Appreciate the feedback 🙏
Best
If one is sitting for a long periods of time, wouldn't it have the same issue as when in bed for 6 to 8 hours? The fascia has then shortened so, it would stand to reason that it would then be painful when one gets up?
I have a wooden roller to gently exercise my foot without weight on it and its very nice just having my foot on it. Its curved so supports the arch of the foot. This lessens the pain to non existent when I do have to get up and walk - eg to simply go get a coffee/food etc.
At night I am wearing a arch support around the foot which has definitely helped. Last night I didn't....and its more painful this morning. So, will ensure I wear it at night.
Thank you for providing us the sufferer’s of plantar fasciitis with this excellent info and advice. 👍❤️
This is the most valuable info I ve heard👍
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.
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.
Best video with genuine information about this problem,
Thanks. I appreciate the feedback. Glad it was helpful.
This is the best and most honest video on plants heel pain, Tnx very much for the information
You’re most welcome. Thanks for commenting 🙏
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.
Have you made any progress? I'm looking for some hope from anyone who actually healed from this condition!!
I am so impressed with this video. It was clear, concise, thorough, and straight-forward. Well done. And, thank you!
You're very welcome. Thanks for taking the time to comment.
To all people with PF, check if you maybe have functional hallux limites. This will interfer with your windless mechanism and will put a lot of stress on your plantar fascia. See if your podotherapist can mobilise your big toe again. This could solve your PF.
Thank you for this very informative video! Your video is the first one I’ve watched that clearly describes the plantar fascia, the makeup of it and the thickening of it from the damaged fibers. Also you’re explaining the treatments step by step is the only explanation I have seen outside of my doctors office. I had several cortisone shots and all of them lasted 3-5 weeks, then the pain returned just as you described. I’ve stopped receiving them and have since been taking a collagen supplement and each morning before stepping out of bed, I slowly place weight on my foot and stretch out my calf muscles before walking. This has helped me a lot but I still have the pain at times. Some days are great and some mornings are better but I think my work still aggravates it. I’m a year and a half so far dealing with this, I hope it gets better soon. Thank you for your information.
Thanks for the kind comment. It can be a very frustrating condition that really tests your patience. Hopefully it will settle down for you soon.
I could cry!! I’ve had PF for 6mths and it’s getting worse!! I’m having shockwave treatment atm…second treatment this week. That’s extremely painful though, I’m not looking forward to getting it done again. Just hoping it helps.
I’ve tried stretches, iced bottle on foot, resting, hot water bottle, toes spreader, in soles, ball 🥎 on arch… I think running and flip flops were the cause. I’m not over weight. I’m in the age range of getting it though, aged 50. It’s soooo frustrating. Getting it on my right foot now a little as well as my left. I had PF in 2019. It took 5mths to go. Good luck to anyone suffering…I know how you feel!!! 💔😭😭😭
Well done . The best video on the subject on youtube.👟
Thanks George. Much appreciated. I'm glad it was helpful.
Very clear video and I appreciate you showing the average time to heal and what can be done that is research based
You’re very welcome Tom. Glad you found it helpful.
V well explained and the most logical video without any boastful techniques to reduce the pain.
Thanks for the feedback 🙏
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
Very helpful information. Thank you 🙏.
Glad it was helpful. Thanks for commenting.
Excellent! Thank you.
Thanks you very much for the good idea please help me to get rid of this problem on my heel pain
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.
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!
Brilliant, I understand now what is going on….thanks so much
You’re very welcome.
I tried all of the exercises in every TH-cam video. Only going to the podiatrist and getting injections in my feet helped. Then wearing cushion shoes every time I stood up.
Thanks for sharing. I’m glad it helped. Yes I am doing more injections recently. I do them ultrasound guidance and they do seem to work well. The research doesn’t agree though.
What about the heat that I feel on the fascia,is that the inflamation?Amazon worker.....10 hrs on feet per day.See I been doing exercises from physio whilst still inflamed😢
This has been most comprehensive info I've seen up until now.Thanx
Thank you. Looking for answers and have tried so many things. Carrying overload seems to be a factor. Extra weight pressure definitely increases the pain. But it’s hard to avoid. I’m always carrying or lifting something. Have done so many things and my podiatrist said he ran out of suggestions and treatment so viewing other videos like yours. Time, exercise, constant stretches , would like to decrease 10 lbs, inserts, 1/2 size larger shoe, toe separators for period of time, shoes with bigger toe box and more ….. my goodness. Using an elevated chair would be nice when I have to stand for more than 1.5 hr. I do a little dance movement to vary the pressure. Having an elevated chair is an issue for the work environment so thats out. Losing 10 lbs would be an answer but have not been able to make that happen. Gotta keep working at it. Good luck folks. Never give up. Thank you doc for your realistic and informative video.
Your’s is a common story. There is an opinion amongst some clinicians that the wide variety of treatments available just keep the patient entertained while it eventually gets better by itself in the background. Food for thought.
I'm suffering again, one foot only, after years of no symptoms, agony on my heel and I work 4 hour shifts stood up and constantly walking up and down, I took a stool in to work to give me breaks, as i end up hobbling on the side of my foot. I normally live in high ankle type boots, no orthotics needed, wondering whether changing footwear due to seasons plays a part, though my sandals come with arch support. I'm not overweight whatsoever, Ive bought several orthotics and some actually make it worse, especially those that have a pronounced bump in the centre, feels like I'm walking on a marble, and some are far too hard, gel heel cushions hurt, i get more relief with memory foam heel pads which you can pick up at bargain stores in the UK . Im currently using my tens machine and a foot massager to stimulate blood flow, heres hoping it doesnt drag on 😢
Im thinking my gait plays a part , I wear down the outside of heels so maybe under pronation, plantar fasciitis, mortons neuroma in the past and inner knee miniscule tear, all left side.
I find this information very helpful and the doctor speaking very confident and knowledgeable of the symptoms and also the treatment, I used to work as a nurse. I was on my feet for 12 hours a day. Then I had to give up work through an instant at work. In the last 5 years I've taken up my passion for art and during this time I'm usually standing so I can take the point where you say too much standing or exercising can bring on these symptoms of plantar fasciitis. It's given me room for thought on how I can ease the discomfort, I would like to thank you for your informative video on this treatment. Thank you for your help and have a good day 🇬🇧👍🏼
Thanks for the kind comment. Much appreciated. I’m glad you found it helpful. Very best wishes.
Good man - sensible no BS information.
I appreciate that. Thanks.
Divorce caused my plantar fasciitis. I am only partly joking. We had two beagles, and they needed to be taken on long walks several times a day. I did the morning and evening walks, and my wife did the two mid-day walks. When she left me, the dogs stayed with me, I was suddenly responsible for all four walks, half an hour each, totalling two hours of brisk walking a day. After just a few weeks of this, I started to experience foot pain, which turned out to be plantar fasciitis. This has been going on for at least six month now. Since my dogs do need their walks several times a day, I can't see much chance of cutting down on the exercise load, unfortunately. I will try using the other fine methods, such as shoe inserts, stretches, and splints, and hope they help.
Good luck. Not an easy situation to manage but it usually burns itself out eventually.
Great answers to many questions which are actually common sense. Last time I had this was because my doctor said I should start exercising. So I did, and end up injured, took a bit for it to go away. Now, my exercising is my daily workdays but not weight lifting or running but I am still moving alot. And I am on my feet regardless possibly far too much. What I have found from all this is that exercising is harmful and not exercising is harmful. So either way we're all screwed! 👍
That’s a great comment. And you are quite right. Exercising for problems like this is a balancing act. It’s easy to do too much or too little. Thankfully it usually gets better after a few years regardless.
Thank you so much for an easy to understand evidence based review of this condition!
You’re very welcome Julia. I’m glad it was helpful.
thanks. This talk is the most comprehensive one i have see on youtube
I agree with others commenting that this is the best plantar fasciitis video. I would also like to compliment on the bookshelf ends from the collectors edition of the Lord of the Rings films (I have them as well).
After watching this, I do wonder if what I have, as a wannabe runner, is truly plantar fasciitis. The pain tends to be more towards the arch of the foot rather than the heel, and recently it seen to resolve within a day of appearing. Several months ago I had bottom of the foot pain lasting for at least several months it seemed, although never severe, it did keep me from running. In the past, I had been diagnosed with plantar fasciitis, but that was years ago (also from running).
Thanks. I appreciate the feedback. Whilst the vast majority of plantar heel pain is on the inside of the heel, there are variants where the pain is felt on the outside of the heel (the lateral band of the plantar fascia) or in the arch itself. With arch pain it’s also common to get small lumps within the arch called ‘plantar fibroma’ which is a sister condition. These are harmless but can be irritable.
Well explained all factors in short time!!
Thanks 🙏
I just had this condition for the first time in my life due to my workplace requiring leather shoes. It comes and goes, but when it comes, it hurts! Buying a synthetic leather shoe (which feels more like sneakers in formal disguise) helped relieve it a lot. Wearing my Fila sneakers also helps. But since this has gone unchecked for months now, it's not really doing much apart from doing some small exercises to gradually strengthen it. It's really disabling.
Well I hope you find something that helps. As I said though,unfortunately there is no quick fix.
Catch 22: If being overweight is one of the causes of Plantar heel pain, one needs to exercise to lose weight - but doing so, aggravates the plantar heel pain!
I've been trying to increase my exercise by gentle walking, alternating between standing at my rising desk or sitting. Its not a huge amount as I was taking it gently but here I am with the heel pain.
I loathe wearing shoes/slippers in the house. So finding something supportive that allows at least my toes to be bare is difficult. I've found some wraps with a gel support in the arch which seems to help and wearing these at night has helped but this seems to be a long journey, Also, not sure the gel support is supportive *enough*. I have extremely high arches and there is still a gap underneath.
Lets hope I can get these reversed and healed and find a way to lose weight too.
This is a very good video and not sensationalising or dismissing the issues experienced.
A question - if the fascia collagen is breaking down, could boosting collagen levels through supplements help?
Following
Hi and thanks the comment. Its a good question but unfortunately eating collagen doesn’t mean your body will grow more healthy collagen.The collagen supplement is broken down in your stomach into its constituent amino acids, the same as any other protein. It then just gets added to the nutrient soup in the intestines and eventually crossed into your blood stream ready to be synthesised into one of many proteins required by the body - including collagen.
Good luck with the rehab and weight loss. I know it can be hard but weight loss is mainly achieved through diet - so thats where i would be focusing.
Best wishes
Stephen
Perhaps look into Finn Comfort sandals. They are very expensive, but have a very supportive, and replaceable, footbed and can take orthotics. They also can be re-soled, so the expense is reduced over long-term use, if you maintain rather than replace.
You may already be doing this, but I find that the pain of those first horrible few steps in the morning can be avoided, or at least made manageable, by pausing to sit on the side of your bed, crossing your affected leg, and using the hand on the same side as your PF foot to pull your toes back gently, but firmly, and also gently but firmly use the opposite thumb to massage the plantar fascia. Do this before those first few steps and it will likely make it more comfortable (and maybe over time help the healing go faster because you’re avoiding insult to the injury).
Best of luck to you. The journey is very, very long. I know, because I’ve had PF three separate occasions, so it is not overstating to say I’ve had it for years of my life. Fortunately, I lost some weight and have increased my fitness and activity and have not had it in many years, though I’m always on the lookout.
This is just a great presentation!
Thanks ☺️
Thank you for the good explanation. I had leg problems for a few months and heel pain for weeks but doctors and pharmacists couldn't & didn’t diagnose it properly.
After watching a video on foot taping for PF the other day, I realised my condition. I put tape, did icing, rested my foot and it was much better. Then after watching some "fast cures for PF" videos yesterday, my foot became worse after doing all the stretching exercises shown. I believe it was too early to do them.
You are the first Western physiotherapist who has recommended acupuncture. I do home acupuncture for myself and did it on my foot after watching your video. Thank God, it felt much better. I will rest my foot further and do more acupuncture for the next few days. Thank you once again. God bless! ☺️
Thanks for the kind comment. I’m glad you found some relief. I hope it settles down quickly for you. Best wishes.
@@PhysioMSK Dear Sir, I want to report on my progress 😊
After doing acupuncture on my foot yesterday, it is now almost normal and I didn't feel the pain this morning. I was so delighted because i thought i had to rest in bed. But seeing how well my leg had become, I decided to do the day as usual.
Just now when I looked at my acupuncture notes, I realised I did do it on my foot but in the WRONG place in February this year. I did it all over the ball of my foot. And the relief was minimal.
Yesterday after watching your video & studying your pic where the plantar muscle ended, I did it mostly on that part. And the needles hit the right spot! 😱👏🥳
I hope my new report will help you or someone in future.
Thank you once again 🙏
BTW, ironically your video is now an "instant" PF cure for me 🤣
Thanks very much for commenting and sharing your experience. I’m glad you found something that helped. Best wishes.
@@PhysioMSK Another progress report ☺️
This might right help those with no acupuncture means.
I used the tip of my rounded acu pen about 1/2" in diameter (you can use something similar) to press hard and massage the problem deep tissue points on my sole. You will know which part, from pressing & comparing with your good sole, as there will be a difference.
Painful but utterly gratifying.
Thank you for this excellent discussion 👍
You’re welcome. Thanks for the comment 🙏
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.
Yeah this is a great informative voice. The best I've seen so far. 👍👍
Thank you ☺️
This condition is so frustrating, and there is so much contradictory information out there about how to heal it. It just won't go away. Completely disrupted my walking/running routine, which is so annoying!!
I agree entirely. That’s the reason I made this video. No BS. Just the evidence.
I totally understand...all these modern marvels and we can't stop a mere heal discomfort?
Fantastic information- thank you so much - greetings from South Africa
You are very welcome - from sunny (occasionally) England !
I'm going on two years by summer's end. I tried the walking boot but messed up my knee! I have discovered that a low heel is best for me as it seems to pull less on the heel spur.
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.
I got it 3 months ago, i can't even walk without wearing some sort of shoes anymore, so i'm wearing crocs inside. Havent tried any of these methods before so hopefully they work, ive only been using a massage gun. (Doesn't work much)
I really encourage you to get a pair of well-fitting trainers exclusively for indoor use. Crocs do not support your foot at all.
“opathy” means diseased or having a disease. “Osis” or tendinosis or faciosis is more accurate. Plantar fasciosis is
caused by degeneration of the plantar fascia, usually due to chronic stress or repetitive strain. Symptoms are similar to plantar fasciitis, but the pain is not caused by inflammation.
I agree. I've never seen a single case of 'plantar fasciitis' in my career. There is never any inflammation on ultrasound. Its always degenerative. 'osis' is technically correct but never used in this condition. 'opathy' is less correct but still better that 'itis'. All very confusing for patient's which is why I prefer 'plantar heel pain' which is 100% correct - and it de-medicalises the condition which i think is hlepful.
Thanks. Sensible. Correlates with my GPs advice.
I didnt want to manage my symptoms of akiles tendinitis and plantar fasciatis, I wanted to fix the problem!!! I suffered from these problems for 30 bloody years !!!! In the morning i couldn't simply walk. Currently i started learning about body mobility and it was a LIFE SAVIER!!! SPECIALLY ANKLE AND FOOT MOBILITY. Theres plenty of videos about iton youtube and also streching my knees and hip flexors helped alot . They all conected. I also applied CASTOR OIL PURE, helped my pain go away .. and finally i could bear walking bare foot and bought my pair of bare foot shoes that have been helping alot!!! Currently i have no akiles tendinites nor plantar fasciates. I cure myself !!!
Well done 👍
Can I ask you what castor oil you used like what brand
6 and a half years I've had this. I am almost at my wits end with it.
That's ceetainly much longer than usual. I hope you find some helpful information in the video.
@@PhysioMSK Thank you so much for the video. 🙏
Any updated info on this since it was filmed? Thanks
I wish there was. But sadly no.
Thank you for the Excellent info and advice. 👍❤️
Thank you great content
You're very welcome. Thanks for commenting.
Thanks, this seems very sensible
I certainly agree with you Annie.👍
I am having a bad case of Plantar Faschitis, im surprised you didnt mention LLLT /cold laser therapy, which in USA some physical therapists have and NIH data seems to indicate he provides some pain relief, I had some luck with it before but was in consistent w the therapist, im now trying again w a different clinic. Your thoughts? My problem is not from standing its only after resting, driving, sitting, etc...once im standing or walking around im fine, its when i stop.:))
The evidence for cold laser / LLLT is for very short term relief only - which is akin to taking simple pain killers and a waste of money in my opinion. If your pain is mainly at rest then I would question the diagnosis. Have you have inflammatory screening blood tests and/or any form of plantar fascia imaging ?
This is definitely the best dicussion. Thank you
Glad you think so!
4. Will it ever go away and not come back?
I don't know. Most will get better but can take an average of 2 years. Unfortunately some do persist for much longer but they are the tiny minority.
excellent video - thank you doctor. a question if I may: does cycling aggravate the plantar fascia or inhibit healing?
Cycling is a non weight bearing exercise and so shouldn’t affect the plantar fascia. The exception being lots of ‘out of the saddle’ work which could potentially cause some irritation.
@@PhysioMSK Thank you so much for responding, and so quickly! Greetings from Canda, and all the best to you and yours.
Thank you for this informative video, much appreciated
Glad it was helpful!
excellent info and advice. 👍❤️
I’m trying a regimen of deloading with a walking boot. Hopefully that works as this has been going on too long.
good vid, thank you. surprised you didn't mention prolotherapy.
Thanks. There really is no supporting evidence of any quality for prolotherapy, which is essentially just injecting sugar water into someone’s plantar fascia. That’s why it was omitted.
@@PhysioMSK there's lots of evidence for it. here's one article: www.ncbi.nlm.nih.gov/pmc/articles/PMC4938120/#:~:text=Many%20observational%20studies%20were%20of,psychometric%20measures%20reported%20positive%20findings.
Very helpful video, thank you
You’re very welcome
I have seen no mention of pain in the ball of the foot. It's like walking on coals after walking a few kilometres (in both expensice running and hiking shoes). Most visuals show the connection at the heel as focus of pain. I meet all other criteria of PF.
You probably don’t have plantar fasciitis. You probably have metatarsalgia or a plantar plate issue.
Great info
Thanks
Glad it was helpful!
Where are the links he referenced for various products?
In the video description
Hi , sorry I'm a bit new to this . Where do I find the link to the insoles for gel heel and planter support .
@@cabbyman63 it’s in the video description.
Thanks. I have left foot PF. I have a knobbly ball which use on the floor to massage the area forward of my heel. It is painful to do and the facia is quite hard. When I do the same to my right foot it's not painful at all and not hard. I've had this PF issue 6 months now and it's very frustrating as I want to run for my health.
Follow the advice in the video. It was made for people just like you. Best of luck.
Thanks so much for this helpful information. I was hoping for a fast cure, but now I understand this is a long healing process. In the meantime, I’m vacationing in Turkey for three months and I’m only on my third week. I wonder if I should return home to let my leg heal, or continue sightseeing every other day to allow my foot to rest and recuperate a bit.
I would just get on with your holiday. It’s only pain. You can rest when you get home. Good luck.
I trust this information. Thank you.
Thanks. I hope it helps.
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.
Thanks for the information 👍
No problem 👍
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.
In concept, taping seems to apply more pressure. What does it actually do ?
Taping is designed to lift the arch and offload the plantar fascia.
This is my first time watching you and your information. I learned more from it than in several years of watching others. I really want to get some insoles, but all your references seems to indiciate they are for people with flat feet. I am looking for an insole for the heel and arch, but that supports a high arch. Are they the same, or is there another one you can recommend. When I click on your links, I am confused by the number of arch supports that are listed.
If you have high arches then you probably just need the pressure relief gel heel inserts. But the arch support Orthotics can also be helpful for high arch feet. They will just take some of the strain off the PF. The problem you might have is knowing how high your arch is and therefore how much arch support you would need. Best option might be to see a podiatrist.
I am 76 just started to have the problem on my right foot
It’s unusual to develop PF as your age. What have you been doing ?
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.
Tanks for information ❤
What is the difference between the type of re-injuring created with shockwave therapy and the reinjuring that occurs in the morning when putting weight on fascia that have been in extension all night?
Its a good question. Shock wave is very controlled and targeted and aims to cause 'microtrauma' in order to stimulate a healing response. Morning weight bearing pressure will tend to cause 'macro trauma' which overloads the tissue and causes a much stronger tissue reaction. Its all about getting the balance right of doing too much v too little - and it can be difficult.
Thanks for the information! Any thoughts on prp or bpc 157 to help recover from PF?
No good evidence for either I’m afraid.
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.
Thank you.
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 🤞
Hello! is it possible to train legs with this injury? (squats, deadlifts, etc)
yes certainly - in addition to the specific foot exercises described in the video
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.
How long should one wear the insole. I had insoles for 1.5 years, my pain went down approx 80% but got stuck at this point. Wondering if I need a different approach now.
Yes I would say you need a different approach. The insoles are just for pain relief. They don’t cure the problem. I would suggest following the exercise and stretch advice.
Does this condition cause your ankle to shake
No. That’s not a symptom of this condition.
I will add my personal anecdote regarding treatments that don’t necessarily work: MLS laser therapy. I just finished a course of 10 laser treatments over 4 weeks (at a total cost of $550, insurance doesn’t cover) and it did nothing what-so-ever to help.
Yeh no evidence for laser therapy at all I’m afraid. Not sure why people ever thought that shining a bright light on any soft tissue would help. Never mind. Lesson learnt.
Ive tried all the stretching and tennis ball but they all made my pain worse, i then tried the “toe squincher” as recommended by jeff Galloway, which really seems to be helping 👍🏻 what are your thoughts on using a TENS machine on heel pain?
TENS might provide some temporary pain relief but it won’t alter the structure of the plantar fascia in any way.
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.
I was asked to do a small hardball, like a cricket ball rolling over my foot. i have been doing so before i get into my night sleep, do help.