Heel or foot pain from plantar fasciitis is a very common problem that can occur at any age, usually occuring after trauma to the foot and so typically only affects one foot , but can occur on both feet at the same time.
The plantar fascia is an extension of the Achilles tendon which runs under the heel then spreads out across the sole of the foot and inserts into the base of the toes. Its function is to provide shock absorption on the sole of the foot as well as to lift the arch of the foot when walking.
Plantar fasciitis is inflammation of the plantar fascia which causes pain under the heel or in the instep which is usually worst either first thing in the morning when one gets up or after a period of non-weight bearing rest and one puts weight on the foot. The pain will often initially ease with movement, but after a while overuse will aggravate it too.
It can occur suddenly or gradually develop over time. Its cause is not always clear, but it is usually associated with following either some form of trauma to the area or overuse.
- Treading on something hard, like a stone, whilst barefoot
- Being on your feet for extended periods of time longer than you are used to whether walking, running or standing, especially if on hard surfaces like pavements).
- Using a treadmill in a gym. When we walk outside the surface is never completely flat and our feet are constantly adjusting to the tilt of the surface undergo a lot of movement and rarely land exactly in the same place. On a treadmill however, the surface and the movement we make is always exactly the same which can have the effect of creating a repetitive strain or trauma on the plantar fascia. This can be exacerbated if the treadmill is tilted to mimic uphill walking which will also overstretch the fascia at the same time.
- Inappropriate footwear – very flat shoes with little or no support or cushioning shoes especially if they have a very thin hard sole (eg. womens ballerina style shoes or mens smart leather work shoes)
- A sudden stretch to the sole of the foot whilst exercising, for instance if it involves jumping or sprinting suddenly in sport (eg. squash or football)
- Being very overweight
- Having tight Achilles tendon and calf muscles
- Combinations of any of the above factors
Although it will eventually resolve it can often take months to do so even with conventional medical treatment involving painkillers, anti-inflammatories, gentle physio exercises and rest. Acupuncture, however, can bring about speedy resolution of plantar fasciitis by opening up blood flow to the affected area, breaking the cycle of inflammation and bringing it down, relieving pain and stimulating the damaged tissues to heal.
Article by Richard Collisson acupuncturist at the Health Zone Clinic in Wimbledon
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