Plantar Fasciitis slowing you down? Direct Access can help even without a prescription.

Plantar fasciitis is a disorder resulting in pain in the heel and bottom surface of the foot. Plantar fasciitis is one of the most common causes of heel pain and has been found to occur in approximately 10% of people at some point during their life. This may result in them visiting a podiatrist kansas city facility or one more local to their doctors so they can get the treatment they require.

The plantar fascia is a broad band of connective tissue that runs across the bottom surface of the foot and connects the calcaneous (heel bone) to the heads of the metacarpal bones (bones between toes and bones of the mid-foot). The plantar fascia is the primary arch support to the bottom of the foot as well as acts as a shock absorber during contact with the ground when walking or running.

Symptoms of plantar fasciitis are typically slow to develop and are brought on by a variety of risk factors. Potential risk factors leading to heel and foot pain associated with plantar fasciitis include, but are not limited to, the following:
• Prolonged standing on flat surfaces
• Excessive running
• Inappropriate footwear
• Flat feet (Pes planus)
• High arches (Pes cavus)
• Achilles tendon tightness and calf muscle weakness
• Inward rolling of the foot during walking or running (excessive pronation)

Signs and symptoms typically related to plantar fasciitis include:
• Sharp pain in heel of foot (see distribution to the right)
• Unilateral foot pain (most cases)
• Intense pain following first steps after getting out of bed or prolonged sitting
• Symptom improvement with continued walking
• Rare, but possible symptoms: numbness, tingling, swelling, and radiating symptoms

Pain from plantar fasciitis can often be resolved with non-surgical physical therapy interventions and conservative treatments:
• Manual Techniques: Hands-on techniques performed by a licensed PT or PTA include soft tissue release to tight or inflamed muscles and joint mobilizations to improve ankle joint capsule mobility
• Therapeutic Exercise: A specific exercise program will be developed individually for each patient regarding their specific needs based on findings during the initial examination. Exercises performed in therapy will aid in improving strength, balance, coordination, muscle length, etc.
• Stretching: Passive and active stretching techniques utilized to improve joint and soft tissue mobility providing proper alignment of the joint.
• Occupation/Sport Specific Exercise: Integration of occupational and sport-related tasks into a customized therapy program will allow a faster transition and return to the prior level of function.
• Assessment of foot mechanics: A skilled PT can assess foot structure and mechanics when standing and walking. Prescription of proper footwear or orthotics like plantar fasciitis insoles may be made to improve arch structure when in a weight-bearing position.
• Modalities: Various modality and anti-inflammatory treatments will be utilized in conjunction with therapeutic exercise, stretching, and manual techniques and include: interferential electrical current, vasopneumatic compression, ice massage, ultrasound, iontophoresis and phonophoresis.
• Home Exercise Program: A tailored exercise program will be provided to each patient to perform between physical therapy sessions. Continued performance of HEP is vital to maintain progress made during therapy session, and aids in effectiveness of physical therapy interventions.

According to literature, “approximately 80-90% of people suffering from plantar fasciitis will have a complete resolution of their symptoms in 6-18 months, with or without treatment.1-2 Conservative treatments include non-steroidal anti-inflammatories (NSAIDs), orthotics, heel cups/cushions, night splints, Achilles tendon stretching and physical therapy treatment (including exercise and modalities such as ultrasound, phonophoresis, iontophoresis and friction massage). All of these interventions have demonstrated some positive effect in the outcome of plantar fasciitis 1-2 however there is no consensus as to which modality or combination of modalities is the most effective.”

If you feel you are experiencing heel or foot pain from plantar fasciitis you may benefit from contacting your physical therapist for consultation and treatment. Physical therapists are now able to practice under a practice law known as direct access. Under direct access, you may be seen for 6 visits or 30 days without a physician’s referral. The physical therapist is a licensed clinician skilled to evaluate and treat musculoskeletal injuries and will be able to refer onward to physician if further consultation is warranted.

1. Tisdel CL, Donley BG, Sferra JJ. Diagnosing and treating plantar fasciitis: A conservative approach to plantar heel pain. Cleve Clin J Med. 1999;66:231-35.

2. Singh D, Angel J, Bentley G, Trevion SG. Fortnightly review. Plantar fasciitis. BMJ. 1997;315:172-75.

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