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Your Best Foot Forward: Walking through Heel Pain and Plantar Fasciitis

Each morning you wake up, have you ever felt like your first steps are like walking on glass? Have you ever waited for this feeling to settle in?

You may be feeling plantar fasciopathy, and it is common among middle-aged women. Menopause or reduced oestrogen may be a cause, but there is more to it, so let’s take a look.

WHAT IS PLANTAR FASCIOPATHY? WHAT CAUSES IT?

The plantar fascia is a broad band of fibrous tissue stretching from the heel to the base of your toes. This tissue assists in the stability of the arches when you are walking or exercising.

When women have plantar fasciopathy, or as we mentioned, the heel pain typically occurs in the morning, it is usually because of the loss of estrogen affecting collagen production. Since collagen is the building block of the musculoskeletal system (mostly the ligaments, tendons, and skin), its loss affects the elasticity of the plantar fascia. This makes the tissues less adaptable to load and even everyday physical activities. For pregnant women, oestrogen mediation can soften the plantar fascia as well, or the increase in body weight can make it difficult for the tissue.

Other factors cause plantar fasciopathy, such as:

  • Being a woman between the ages of 40 and 60
  • Increase in intensity of weight-bearing activities or exercises
  • Increase in weight, like obesity or pregnancy
  • Tight calf muscles or ankle joint stiffness, resulting in reduced ankle mobility or flexibility
  • Foot posture, whether high or low arch of the feet
  • Footwear with poor cushioning for the foot arch
  • Standing for lengthened periods

WHAT CAN WE DO ABOUT PLANTAR FASCIOPATHY?

Treatment can vary on the pain-dominant phase or the load-dominant phase. Speak to your women’s health physiotherapist so you can identify and manage your symptoms for the treatment you specifically need.

Help treat your plantar fasciopathy when in the pain-dominant stage through the following strategies:

1. Lifestyle Modification

  • Avoid walking barefoot. Make sure to use footwear with good cushioning for ideal ankle support.
  • Reduce long periods of standing.
  • Manage high–impact exercises. Instead of running or jumping, try lower-impact training such as cycling, swimming, or aqua jogging
  • Pace your daily physical activities. It is important to keep active, but do so in intervals or manageable loads.

2. Supportive footwear

  • Wear shoes with soft-cushioned soles that fit you well, both in length and width.
  • Try wearing shoes with short heels, they may be more comfortable than completely flat ones.
  • Use heel pads or gel heel cups. Thick, soft foam or gel pads may improve the ergonomic quality of your footwear. Try taking a few steps with these in the morning to avoid walking barefoot on hard floors.

3. Ice massage

  • Gently roll your feet from toe to heel over a frozen bottle or can. The cold, soothing factor may be a gentle trick to prevent symptoms.

4. Stretching Exercises

5. Strengthening exercises during load dominant phase

  • A strengthening exercise programme can improve calf muscle strength to normalise plantar fascia tissue structure to tolerate load.

6. Other treatment options

  • Medications: Nonsteroidal anti-inflammatory drugs or NSAIDs
  • Taping
  • Podiatry referral for assessment of shoe inserts
  • Extracorporeal shockwave therapy to stimulate healing
  • Surgery

As you perform these exercises and treatments, you may feel some discomfort for a while. If it lasts or symptoms persist, talk to a women’s health physiotherapist to determine if you must continue. They will also serve as your guide to what the best exercise programmes are for you, as you restore your strength and flexibility.

If you are suffering from heel pain, please call or WhatsApp us at 9780 7274, or email us at help@embracephysio.sg to discuss the treatment you need. We’re here for you!

Feel free to look through our website, where you can learn about other women’s health conditions we treat. This is a safe space where we can discuss how we can help you with physiotherapy.

Note: While I am a physiotherapist, I am not your personal physiotherapist. The contents of this website are for informational purposes only and are not intended to serve as individual medical advice.

References:

  1. James L. Thomas et al. The Diagnosis and Treatment of Heel Pain: A Clinical Practice. Guideline–Revision 2010. The Journal of Foot & Ankle Surgery 49 (2010) S1–S19.
  2. Rathleff et al 2014 Page 5 of 5 Rathleff MS, Mølgaard CM, Fredberg U, et al. High-load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12-month follow-up. Scand J Med Sci Spor 2014:n/a-n/a doi: 10.1111/sms.12313 [published Online First: Epub Date]|.
  3. Sullivan et al. 2015. Musculoskeletal and Activity-Related Factors Associated With Plantar Heel Pain
  4. Plantar fasciopathy
  5. Causes of plantar fasciopathy
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