G'day, my name's Fergus. I'm a Sports Physio. This video gives you some information about a common injury I see.
This is Jon. He's come in with a heel pain - a plantar fascia pain in his right foot. Plantar fascias we see come in - they can be sore for days or weeks or months or sometimes people come in and they've had heel pain for years before they decide to do something about it. They're generally sore in the mornings , first thing when they're out of bed, first few steps out of bed and then they warm up and start to feel a bit better. They're worse after you've done exercise the night before, so you might have been for a jog or a walk. Jon's is a bit worse because he's training to go to Kokoda in a few weeks so he's increased his training load.
The plantar fascia is along the sole of the foot. The word "plantar" just means the under-surface of something. And a "fascia" is a layer of tissue, generally wrapping a group of muscles, holding a muscle group in place. So the plantar fascia is a tough tissue from the heel down to the front of the foot. It helps in the "Windlass mechanism" as the arch of the foot flattens out when you land, the plantar fascia helps with that shock absorption. So the plantar fascia anchors on to the heel bone as well as the tendons of those foot muscles. And essentially it gets over stretched when you're landing - when you're walking on it. Particularly with more dynamic things: jogging, hopping, jumping, skipping. So it's an irritation at the heel bone where there's that traction or pulling of the fascia on the heel bone. So that's the plantar fascia
Treatment wise... So, at the moment he's sore in the morning, he's sore when he hops, he's sore with a single leg calf raise. It's a pretty easy diagnosis - three'll be a tender spot , usually on, slightly on the medial side of the insertion on that heel bone. You might have a stripe of pain up through that medial longitudinal arch.
Treatment wise, he's got some orthotics. I want him to stay in shoes as much as he can, particularly something with a bit of a heel raise. The most important thing is modifying those things that aggravate his pain. So we're backing him off his more explosive training, the hopping, jumping, running. And then the next most important thing is a strengthening program to increase the load bearing capacity of the tendon. So I've got him doing an isometric single-leg calf raise. And I like long holds, trying to accumulate 10 minutes a day of a long hold single-leg isometric calf raise.
Adjunct sort of things, I've got him on a course of Ibuprofen for a couple of weeks. He's in orthotics. We can tape, low dye taping, or that medial arch support taping. We can try him on some green tea - three cups a day of green tea. And we like some hands-on treatment down through that plantar fascia.
The initial strengthening exercise I want Jon to start is an isometric single-leg calf raise. It's a good early exercise to take the pain out of the heel. I get him to go up on his toes on that foot. He can hang on to something for balance. And I want him to hold up there for an accumulation of ten minutes a day. So he's probably starting with a sixty second hold and he's going to do ten reps. I don't mind if he does it in one session or spreads it out through the day. I want ten minutes of an isometric hold, going up on his toes and holding up there for as long as he can, trying to accumulate ten minutes a day. It's a great exercise to take the pain out of the heel in the initial first couple of weeks.