"Heeling" the pain

While the human body is a miracle of nature, it does come with some design flaws which are the result of thousands of years of evolutionary change.

Consider the height and weight of the average adult human and then consider the size and surface area of the human foot!

While maybe not as civilised, our ancestors had a physical advantage of having four weight-bearing limbs.

Not surprisingly, the modern human foot occasionally has trouble coping with the immense daily demands placed on it.

Not to mention that most people ignore their feet, and the large amount of work they perform for us from the moment we wake.

As a podiatrist, I am frequently asked why I would want to work with feet?

The answer is that the human foot is a remarkable and complex part of the body and essential for human survival.

We rely on our feet to function properly, but when things go wrong with our feet it can be extremely debilitating, affecting all parts of our life.

Fortunately many foot conditions are treatable.

For a practitioner, it is rewarding to be able to help to diagnose and treat difficult conditions which can make a significant difference to a person’s health and well-being.

The human foot is the most sophisticated orthopaedic structure in the human body. It has many roles.

One of its most important is that it is the ‘adaptor’ for the rest of skeleton.

It is in immediate contact with the ground and acts like a shock absorber for the rest of the body.

Without good shock absorption for our skeleton, each step would be jarring and painful.

To provide this shock absorption the foot must constantly adapt and modify its position by flexing and moving all its multiple parts - bones (26), joints (33), ligaments, muscle, and fascia (more than 100 combined).

This process is sophisticated and extraordinarily complex and it happens subconsciously.

To do its job the foot needs to instantaneously adjust from providing a collapsed shock absorbing function to becoming rigid enough to push you forward during walking and running.

One common ailment, which podiatrists see, is ‘heel pain’.

This can be caused by a number of conditions including Severs disorder, referred nerve pain, fractures/stress fractures, heel spurs and a number of other conditions.

The most common condition which causes heel pain is plantar fasciitis. This is a painful and debilitating condition but is also totally treatable.

Plantar fasciitis is caused by a stiffening and thickening of the plantar fascia which is a broad, flat sinewy structure strapped over the sole of the feet, directly under the skin but over the layers of muscles.

There are many reasons why the plantar fascia can become thickened, stiff and sore.

Some of the reasons are poor foot posture from bunions, fallen arches and other changes to the foot architecture.

Other reasons are poor choice of footwear, injury, or a knee, hip or back problem.

Plantar fasciitis can occur as your feet try to adapt to deal with these problems.

Treatment for plantar fasciitis will vary depending on the cause.

Common treatments used at St Johns Foot Clinic include:

  • Low level laser therapy to assist in the repair of thickened and stiff fascia.
  • Myofascial therapy to loosen the soft tissue in the foot to allow the fascia to glide and move normally.
  • Compression therapy to support strained tissue and reduce tissue swelling.
  • Joint mobilisation to reduce stiffness caused by pain and encourage normal foot movement, muscle decompression, orthotic therapy where poor foot mechanics are a factor.
  • Dry needling.
  • Stretching and strength training for the lower limb.
  • Gait re-training.

The prescribed treatment is dependent on each individual patient and factors affecting the patient’s lifestyle, work and other activity.

The majority of patients experience significant improvement for this condition within a month of treatment.

Heel pain is a condition which many people attempt to self-treat and often only see a podiatrist after they have been suffering for six months.

By this time, they have spent a lot of money on remedies from the internet and chemists.

The causes of heel pain are complex and early professional assessment and diagnosis can save you money and considerable time and pain.

If you, a friend or family member are suffering from heel pain then I would encourage you to seek professional advice from a podiatrist.

- Virginia Bower, Principal, St Johns Foot Clinic.
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