TREATMENT FOR HEEL PAIN: THE CONTROVERSY, THE RESEARCH, THE SOLE THERAPY APPROAC
Plantar fasciitis or ‘heel pain’ is inflammation of the ligamentous band that runs from your heel, through the arch and into the toes. It is the most common condition that podiatrists see. The inflammation is often caused due to tearing or pulling of the fascia.
What causes the inflammation?
- High arched foot also is known as pes cavus
- Feet that pronate / roll in too much
- Injury from impact
- Tight muscles – including calf muscles and tight plantar fascia
- A change in footwear
- Increase or change in activity
How do I know if I have plantar fasciitis?
- Pain on the bottom of the heel or inside of the arch
- Pain during prolonged standing
- Pain on initial standing after sleep or prolonged sitting
- Sharp stabbing pain
The Controversy
A little while ago a news article was released stating that ‘sham’ orthotics are just as beneficial as custom orthotics for the treatment of plantar fasciitis. This has created some controversy throughout the podiatry community- why are practitioners prescribing custom devices if they provide the same outcome as off the shelf devices?
Prefabricated vs. Custom Orthotics
Prefabricated orthotics are a ‘one size fits all’ device. They attempt to fit many common foot measurements and conditions. Custom orthotics are designed from the imprint of your foot and made for your specific biomechanical needs. Different densities of materials and additions can be used to achieve different goals.
Why does a podiatrist prescribe custom devices?
Whilst prefabricated devices do provide immediate relief from heel pain, they do not treat the cause. It is also important to remember that plantar fasciitis symptoms will improve over time without treatment- however, if the root cause is not addressed then it will keep occurring.
Custom orthotics will fit better as they precisely mould to the contours of your foot. They allow for more brace rigidity to better align the lower limb and its movement. A prescribed device also allows for customization of the type and thickness or combination of materials. As these materials are usually of a firmed density, custom devices also last longer.
The Research
What do the guideline say?
A revision of clinical practice guidelines in 2014 by the Journal of Orthopaedic and Sports Physical Therapy suggests a combination of therapies:
- Manual therapies including foot mobilisation and massage
- Stretching of the plantar fascia and calf
- Taping of the foot and calf
- Orthotic devices (custom or prefabricated) that support the arch and cushion the heel
The SOLE THERAPY Approach
At SOLE THERAPY, we have our own lab onsite! Sole Therapy orthotics are custom built from the moulds of your feet to meet your unique needs and prescription during a weight-bearing moulding session. Over ten years of innovative research has developed orthotics that not only fix painful feet, knees and back but help strengthen your feet outside of your foot orthoses. Our aim is to strengthen your feet so eventually, you will not need these inserts to keep you pain-free.
"Love your body from the sole up"
