Heel Conditions

Plantar Fasciitis

 

Plantar Fasciitis is a common debilitating condition, which involves the main supportive ligament under the sole of the foot. If it becomes irritated and inflamed it causes heel and arch pain. The most common site of pain is under the heel where the plantar fascia attaches. The plantar fascia can become inflamed, develop small tears and/or form a heel spur. If a heel spur forms this is not the cause of the pain; the pain is due to irritation to the soft tissue.

 

Patients presenting with plantar fasciitis will usually describe pain when the foot hits the floor in the morning or after periods of inactivity. The pain usually settles down only to return at the end of the day.

 

The cause of plantar fasciitis is usually a result of a few factors. These factors result in too much load being placed on the plantar fascia. The foot structures are unable to cope with this increase in stress and become injured. The plantar fascia is commonly overloaded as a result of unsupportive footwear, calf tightness, poor foot function, increasing in training volume and sometimes weight gain. Plantar fasciitis can occur in all age groups but typically develops in patients in their 40’s, 50’s and 60’s.

 

Once an accurate diagnosis has been made and the causative factors have been determined, the condition can be treated. Plantar fasciitis is not a life long ailment and if managed correctly by an experienced podiatrist can be cured completely; however, the earlier it is treated the easier it is to resolve.

 

In its early stages plantar fasciitis is usually managed with strapping, massage, footwear advice and sometimes heel lifts. As the condition progresses treatment may include orthotic control if there is a foot posture problem and shockwave therapy. In severe plantar fasciitis the heel is sometime off loaded with a CAM boot and referral for an injection maybe required.  

 

Achilles Tendinopathy/Tendinosis

Achilles tendinopathy is not an inflammatory problem but rather a degenerative change of the tendon. The tendon often becomes thickened, swollen and sometimes tender palpable nodules. It is a chronic problem which develops over a long period and can be very difficult to settle down. Symptoms usually include stiffness behind the heel or ankle when rising in the morning. With Achilles tendinopathy the tendon usually warms up with exercise only to become stiff and painful afterwards.

 

Accurate diagnosis by an experienced clinician to determine the severity of the condition is crucial. This is will determine to appropriate cause of action.

 

Treatment may include heel lifts, strength exercises, footwear advice, shockwave therapy and sometime orthotic intervention if there is a foot posture problem.

Sever's Disease

 

Sever’s is a painful heel bone condition which results from irritation and inflammation to the growth plate behind the heel. The growth plate is a developing bone made up of softer cartilage cells. As the growth plate unites it becomes a more mature adult bone and this is how bone grows.

 

Sever’s is very common in active growing kids. It usually occurs between the ages of 9 to 14 years old and often during a rapid growth spurt and/or and increase in sporting activity. 

 

Sever’s treatment options can range depending on how debilitating the problem is. Sometimes a short period of rest maybe required to help ease the pain. There are some simple treatment options that can be put in place so your child does not need to sit on the sidelines. If diagnosed and treated correctly and quickly excellent results can be achieved. 

Heel Treatment

 

Shockwave Therapy

The Heel Centre is proud to be one of only a few clinics in Melbourne to have access to the latest in Extracorporeal Radial Shockwave therapy machine to immediately treat and improve heel pain and other tendon injuries.

 

What is Shockwave therapy?

Shockwave therapy is high intensity ultrasound waves delivered in a non invasive way. These sound waves are delivered through a special hand piece to treat heel spurs, plantar fasciitis and Achilles tendon problems.

 

Shockwave therapy can be used to help treat:

  • Plantar fasciitis/heel spur

  • Achilles tendon injuries

  • Sever’s Disease

  • Patella tendon

  • Os good Schlatter

  • Mortons Neuroma

 

How does it work?

  • Increase blow flow to promote healing

  • Increase tendon regeneration

  • Immediate reduction in pain by numbing the area

  • Break up tendon calcification

 

What does it feel like?

The shockwave applicator head is placed over the injured area, which may cause some mild discomfort during treatment. Shockwave therapy only takes up 10-15 minutes of treatment time depending on the area and severity of the injury.

 

How many Shockwave Treatments will I need?

Usually patients require only 3-5 treatments and show an immediate improvement from their first shockwave therapy session. With the second treatment, the pain should further reduce and by the third treatment there should be a significant decrease in pain, which is long lasting. We also help provide our patients with specific strengthening and stretching exercises along with shockwave treatment for excellent long term results.

 

Are there any potential complications with Shockwave Therapy?

There are no known significant complications with shockwave therapy.  Some people may get localized bruising. Other people will feel discomfort for a small period of time. Compared to surgery, shockwave therapy is a safer alternative and should be considered before having surgery.

 

Are there any quality evidence and research articles for shockwave?

 

  1. Clin Orthop Relat Res. 2013 Jun 28., Extracorporeal Shock Wave Therapy Is Effective In Treating Chronic Plantar Fasciitis: A Meta-analysis of RCTs. Aqil A, Siddiqui MR, et al, http://www.ncbi.nlm.nih.gov/pubmed/23813184.
     

  2. Foot Ankle Int. 2013 Jan;34(1):33-41. The effectiveness of extracorporeal shock wave therapy on chronic achilles tendinopathy: a systematic review. Al-Abbad H, Simon JVN, http://www.ncbi.nlm.nih.gov/pubmed/23386759

The Heel Centre

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