LACERTUS SYNDROME

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LACERTUS SYNDROME

Median nerve is compressed at the elbow under a sheet of ligamentous tissue called the lacertus fibrosus.

CAUSES

Develop after intense physical effort, repeated gripping, or wrist pronation (where your palm faces the ground) when the elbow is bent.

Jobs that are frequently associated with the condition include those that involve working at a computer or doing precise work with the hands, like dentistry or surgery.

SIGNS & SYMTOMPS

Affects your sense of touch and motor skills.

Its main symptoms are paraesthesia (tingling), muscle fatigue, and pain that can radiate up to the shoulder.

Patients might also experience a loss of sensitivity and dexterity. This can happen in just one or both hands over months or even years.

  • Tired or heavy feeling
  • Forearm and elbow pain that can radiate to the shoulder blade
  • Muscle weakness
  • Loss of endurance and dexterity (tendency to lose your grip)

EXAMINATIONS

  • SCRATCH COLLAPSE TEST
  • LACERTUS ANTAGONIST TEST

TREATMENTS

PHYSICAL THERAPY

  • Ultrasound treatment
  • Muscle release/relaxation.
  • Shockwave/shortwave diathermy treatment.
  • Muscle strengthening.
  • Muscle stretching

SURGERY

  • Release of Lacertus Fibrosus

Can’t Put the Foot Down Without Pain? Suffering From Heel Pain?

Description/Introduction:

A sharp pain or discomfort in the heel on weight bearing especially after a rest period is a common complaint. It settles down quickly if treated early and given enough rest, but may become worse and chronic if initial symptoms are ignored.

COMMON CAUSES OF HEEL PAIN:
Heel pain can be either due to plantar fasciitis or heel spur syndrome.

A. PLANTAR FASCIITIS
As a person gets older, the fascia becomes less elastic. The heel pad becomes thinner and loses the capacity to absorb as much shock. There may be some swelling, small tears or bruises in the plantar fascia with the pounding force on the heel.

Risk Factors

  • Being overweight
  • Diabetes
  • Prolonged standing or walking
  • Increasing activity over a very short period of time
  • Injury
  • Being flat-footed or having a high arch
  • Wrong or improperly fitting footwear
  • Wearing high heels for long.
  • Athletic Activity: The younger people who are more active in sports, may suffer from heel pain too.

B. HEEL SPURS
A heel spur is a bony growth that develops on the underside of the heel bone, where the fascia is attached. This is a result of excessive and repetitive pulling of the plantar fascia on the heel bone. The heel spur may press into the sensitive nerves and soft tissues, causing pain in the foot. Heel spurs can be seen as hook shaped protrusions in X-rays.

Heels Spurs are commonly seen in:

  • Middle-aged patients
  • Athletes are especially prone to heel spur due to the repetitive stress on their heels
  • Abnormal walking pattern or pronation with fallen or flat arches

Symptoms:

  • Burning, stabbing, or aching pain in the heel or along the arch of the foot
  • Most people would feel it first thing in the morning because the fascia ligament tightens up during the night sleep.
  • Resting provides only temporary relief.

How can PHYSIOTHERAPY SINGAPORE help relieve Heel Pain?

In most cases, plantar fasciitis/ heel spur does not require surgery or invasive procedures to stop pain and reverse damage. Conservative treatments are usually all that is required. At Physio Asia Therapy Centre we will assess the cause and type of your heel pain and treat it accordingly.

Treatment involves using pain relief techniques/modalities and lower limb strengthening program. A physiotherapy session to relieve heel pain might include the following:

  1. Radial Shockwave TherapyA new non-invasive treatment to help with a healing response by the body by causing blood vessel formation and increased delivery of nutrients to the affected area.
  2. Cold Laser:  Works on deep tissue to reduce local pain and helps with wound healing.
  3. Ultrasound: Improves circulation of the inflamed area, thus enhancing tissue healing.
  4. Mobilization & Manual Therapy: Our physiotherapist will mobilise your foot to reduce restricted mobility between the foot bones or muscle. This helps to reduce pain and stiffness.
  5. Foot Taping: Taping supports the foot, placing stressed muscles and ligaments in a restful state.
  6. Stretches/Strengthening Exercises: Stretching the tight muscles/fascia as well as some leg/ankle strengthening exercises can help to reduce the strain on the fascia.
  7. Orthotics or Insoles: We customise insoles to help improve the weight bearing positions on the foot to recover normal patterns of movement.

Prevention Strategies:

  • Wear proper shoes for each activity.
  • Do not wear shoes with excessive wear on heels or soles.
  • Stretch before and after exercising.
  • Pace yourself when you participate in athletic activities.
  • If overweight, lose weight. 
  • Visit a physiotherapist and have it treated early. So Call Us Today.

Call us for an appointment or send your queries to: info@physioasia.com

Sacroiliac Joint Pain/ Dysfunction or Low Back Pain

Description/ Introduction:

The sacroiliac joints (SIJs) play a crucial role in transferring the body’s weight load from the upper torso to the lower limbs. It ranks as one of the most frequent contributors of long-standing low back pain, with around 15%–30% of individuals suffering from back pain experiencing discomfort stemming from these joints.

Pain and stiffness arising in the SIJ are referred to as SIJ dysfunction. This occurs due to abnormal motion and malalignment of the joint stemming from either hyper (excessive) or hypo (limited) mobility.

Causes of SIJ pain:

Joint dysfunction can occur in either traumatic or non-traumatic conditions such as:

Traumatic Causes:

  1. Fall,
  2. Motor vehicle collision,
  3. Myofascial pain
  4. SIJ Ligament sprain
  5. Improper lifting activities, and
  6. Pregnancy (due to increased laxity of ligaments)

Atraumatic /Pathological Causes:

  1. History of lumbar fusion surgery,
  2. Cumulative injuries,
  3. SIJ Arthritis,
  4. Scoliosis (sideways curve of spine),
  5. Inflammatory Arthropathy (swelling in the joint),
  6. Infection

Other Factors:

  1. Appendicitis,
  2. ovarian cysts or torsion, and
  3. pelvic inflammatory disease.

Risk Factors of SIJ pain

Some of the risk factors which may predispose individuals to having SIJ pain are as follows:

  • Obesity,
  • Sedentary lifestyle
  • Leg length discrepancy (one leg longer/shorter than the other),
  • Gait (walking) abnormalities,
  • Persistent strain or low-grade trauma (e.g., while jogging),
  • Muscular weakness
  • Scoliosis.

Clinical Signs and Symptoms of SIJ pain:

  • Pain and stiffness/Discomfort in the lower back, buttocks, and/or radiating pain to the upper leg and/or groin area.
  • Difficulty in bending,
  • Numbness/ tingling in legs,
  • Difficulty sleeping,
  • Difficulty in sitting or standing for long duration,
  • Difficulty in transitioning from sitting to standing,
  • Difficulty in stair climbing, running.

Other Injuries Mimicking pain similar to SIJ:

SIJ dysfunction is not the sole culprit behind all cases of lower back pain. Other prevalent causes of lower back pain may encompass conditions such as piriformis syndrome, issues with the dorsolumbar fascia and musculature, lumbar disc herniation (bulge), lumbar facet arthritis, and pain referred from neurological sources. It is crucial to accurately identify and address the underlying cause of pain and discomfort.

At ‘Physio Asia,’ we conduct thorough evaluations and provide specialized treatment approaches for lower back conditions. Our goal is to alleviate your pain and minimize the likelihood of future episodes.

SIJ Pain Management

The primary approach to addressing SIJ dysfunction in the early stages involves conservative management, which includes physical therapy. The Physiotherapy treatment may involve the following:

  • Posture correction
  • Manual joint mobilization
  • Soft tissue release/Massage
  • Specialized exercise protocol focussing on overcoming muscular imbalances
  • Core strengthening program
  • Low level laser therapy
  • Ultrasound therapy
  • Shortwave diathermy
  • Supportive Braces (SIJ Belt) to stabilize the joint in cases of instability

Prevention Strategies to overcome SIJ pain or Back pain:

  • Stay physically active by engaging in exercises like swimming and walking, and incorporate daily stretching routines to ward off stiffness. Additionally, maintain a healthy diet.
  • Steer clear of prolonged static positions, whether it’s sitting or standing, and prioritize good posture when using computers, playing games, or watching television.
  • Avoid bending and lifting from your back, ensure you bend at your hips and knees while keeping the object closer to your body
  • Opt for a supportive and firm mattress for sleeping, and consider placing a pillow under your knees to enhance your sleeping posture.

References:

  • Gartenberg A, Nessim A, Cho W. Sacroiliac joint dysfunction: pathophysiology, diagnosis, and treatment. Eur Spine J. 2021 Oct;30(10):2936-2943. doi: 10.1007/s00586-021-06927-9. Epub 2021 Jul 16. PMID: 34272605.
  • Rashbaum RF, Ohnmeiss DD, Lindley EM, Kitchel SH, Patel VV. Sacroiliac Joint Pain and Its Treatment. Clin Spine Surg. 2016 Mar;29(2):42-8. doi: 10.1097/BSD.0000000000000359. PMID: 26889985.
  • Chuang CW, Hung SK, Pan PT, Kao MC. Diagnosis and interventional pain management options for sacroiliac joint pain. Ci Ji Yi Xue Za Zhi. 2019 Sep 16;31(4):207-210. doi: 10.4103/tcmj.tcmj_54_19. PMID: 31867247; PMCID: PMC6905244.

Recurrent Ankle Sprains

What are Ankle Sprains and how do they occur?

  • Ankle sprains are one of the most commonly recurring among both general and athletic population.
  • The primary cause of a lateral ankle sprain typically involves the foot suddenly turning inwards with an added force on the body.
  • This twisting force injures the ligaments present on the outer side of ankle, namely anterior talofibular ligament (weakest and injures first), the calcaneofibular ligament (CFL) and/or the posterior talofibular ligament (PTFL).

What are Recurrent Ankle Sprains?

  • After the first episode, the chances of reinjuring the same ankle increases due to an impairment in the pre-injury state of muscles and ligaments of ankle.
  • Due to this, one can develop long standing pain or instability known as chronic ankle instability (CAI).
  • In CAI, the ankle feels unstable or ‘gives way’ usually while walking or doing other activities, but it can also happen in just standing, with other persistent symptoms such as pain, swelling, limited motion, weakness, etc.

What are the causes of recurrent ankle sprains?

Factors associated with repeated ankle sprains include:

  • Decreased muscle strength
  • Limited range of motion in the ankle joint
  • Reduced Balance
  • Impaired proprioception (joint position sense)
  • Ligamentous laxity
  • A high-arched foot type

What do the injury statistics say?

  • Almost 50% affected people continue to experience persistent symptoms such as pain, swelling, instability, and recurring issues for at least a year after the initial injury.
  • Around 10-30% of individuals who sustain acute sprain develop CAI.

What is the Treatment/Management Options?

Initiating physiotherapy promptly following the first episode of ankle sprain reduces the likelihood of recurrence.

  1. PRICE protocol: This protocol is advised for the initial management (24-76 hours) of acute ankle sprains. For more information on how to follow PRICE protocol, please refer our blog on ‘How to Manage Acute Injuries and Pain’
  2. External Support: Taping or Bracing the ankle helps in reduction of swelling, prevents recurrences, and helps in early return to sport.
  • Exercises: Following neuromuscular training helps decrease recurrence rate and enhances overall functional stability.
  • Ankle muscle strengthening
  • Balance training
  • Range of Motion exercises
  • Sport specific training drills (in later stages for athletes)

Note: These exercises should only be performed under the supervision of a physiotherapist.

Surgical Approach:

  • When instability persists or nonsurgical methods prove ineffective, the surgeon may suggest operative management.
  • Typically, this involves repairing or reconstructing the damaged ligaments. The choice of the most suitable surgical procedure is determined by the severity of instability and your activity level. Recovery duration varies based on the specific procedures undertaken.

References:

  • Mugno AT, Constant D. Recurrent Ankle Sprain. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.
  • Sarcon AK, Heyrani N, Giza E, Kreulen C. Lateral Ankle Sprain and Chronic Ankle Instability. Foot Ankle Orthop. 2019 Jun 13;4(2).
  • Hertel J, Corbett RO. An Updated Model of Chronic Ankle Instability. J Athl Train. 2019 Jun;54(6):572-588. doi: 10.4085/1062-6050-344-18. Epub 2019 Jun 4.
  • Al-Mohrej OA, Al-Kenani NS. Chronic ankle instability: Current perspectives. Avicenna J Med. 2016 Oct-Dec;6(4):103-108.

ANKLE LIGAMENT INJURY – WEAK ANKLE

Description/Introduction:

The ligaments of the ankle joint are comprised of the medial (inner) and lateral (outer) compartments. They work together to provide stability to the ankle. The medial ligaments are thicker and stronger than the lateral ligaments because the medial bands form a mass surrounding the inner part of the ankle. This is why it’s relatively more common to see lateral ligament injuries.

Cause of Injury: Twisting/rolling mechanism i.e. walking with high heels, landing on uneven ground, playing sports

Clinical Signs and Symptoms of Ankle Injury:

  • Pain and tenderness with pressure and stretching
  • Swelling
  • Redness and warmth
  • Limping due to pain
  • Difficulty bearing weight on affected foot

Physiotherapy Options to relieve ankle pain:

  • Cryotherapy
  • Electrotherapy
  • Laser
  • Ankle taping
  • Exercises
  • Transverse friction massage
  • Gait assessment
  • Balance and proprioception exercises

Self-Help Tips:

  • Relative rest
  • Elevate and Ice the ankle to reduce swelling and inflammation
  • Support the ankle with a brace and supportive shoe
  • Avoid H.A.R.M. – Heat, Alcohol, Running, and Massage

Upper Cross Syndrome- Physiotherapy for Upper Cross Syndrome

Description/ Introduction

Upper Crossed Syndrome aka “proximal or shoulder girdle crossed syndrome involves a delicate imbalance of muscles. It is characterized by tightness in some muscles (the upper trapezius and levator scapula) on the dorsal side crosses paths with tightness in others (the pectoralis major and minor) along with a weakness of the deep cervical flexors (ventrally) crosses with weakness of the middle and lower trapezius. This intricate pattern of imbalance creates joint dysfunction that causes postural changes as well as pain/discomfort and stiffness in the neck and shoulder. The Physios at our clinics aim to combat Upper Crossed Syndrome and its symptoms by using a variety of treatment techniques and modalities to provide lasting long-term relief.

Clinical Signs and Symptoms

UCS manifests as:

  • Headaches
  • Neck pain or strain
  • Chest tightness
  • Upper back pain, especially in the shoulders
  • Restricted neck or shoulder range of motion
  • Numbness, tingling, and pain in the upper arms
  • Posture changes (Rounded Back and Forward Head)

Physical Therapy for Upper Crossed Syndrome

Physical Therapy helps patients with Upper Crossed Syndrome by helping address the issue at its root cause. A combination of manual techniques, modalities, strengthening exercise, postural retraining, as well as patient education will help treat the symptoms of the condition as well as prevent its reoccurrence.

Services Offered by Us:

Physical therapy can help manage Upper Crossed Syndrome and aid in returning to normal everyday function without difficulty/discomfort. Our PTs are trained to provide relief by doing the following:

  • Laser Therapy and Ultrasound Therapy: Used for heating and promotes tissue healing.
  • Interferential Therapy: Stimulates the muscle and nerve fibers.
  • Shockwave Therapy: to relieve pain.
  • Exercise Therapy: Muscle Strengthening and Stretching and training to improve overall function.
  • Postural Training: for the best positions for weight bearing to reduce stress on the muscles and joints.
  • Education: Learning different techniques to perform daily activities even while being limited
  • Manual Therapy: Manual techniques such as trigger point release is beneficial in improving mobility and reduce pain.

Shoulder Pain- Physiotherapy for Shoulder Pain

Description/Introduction

The Shoulder is one of only two ball and socket joints of the body, this allows it a greater degree of freedom when it comes to movement, at the cost of stability. A painful shoulder can cause hindrances to daily activities such as difficulties is reaching and lifting objects as well as difficulty with tasks such as bathing and dressing/ undressing. Physio Asia Therapy Centre aims to target shoulder pain at the root and build a strong foundation of strength and mobility to prevent secondary injuries.

Clinical Signs and Symptoms

Pain in the shoulder may also present with:

  • Muscle tension around the area of the neck and arm
  • Pain that can be felt radiating down the arm.
  • Swelling and Stiffness around the joint
  • Pain/ Stiffness during reaching for objects and picking up objects from the ground.
  • Difficulty in daily activities such as bathing, eating, and dressing/undressing.
  • Numbness on the joint and even down the arm
  • Muscle Spasm

Causes

Shoulder Pain may be caused by one of the following underlying conditions.

  • Rotator Cuff Injuries:
    • Rotator Cuff Tears: Partial or full tears of the tendons connected to the arm bone. These can result from trauma or repetitive motion.
    • Tendinitis: Inflammation of the rotator cuff tendons due to overuse.
  • Arthritis:
    • Osteoarthritis: Wear and tear of the joint cartilage.
    • Rheumatoid Arthritis: An autoimmune condition affecting the shoulder joint.
  • Bursitis:
    • Inflammation of the fluid-filled sacs (bursae) that cushion the bones, tendons, and muscles near the shoulder joint.
  • Adhesive Capsulitis (Frozen Shoulder):
    • A condition characterized by stiffness and reduced range of motion in the shoulder joint.
  • Fractures:
    • Bone fractures in the shoulder due to direct injury or osteoporosis.
  • Referred Pain:
    • Pain originating from other areas (e.g., neck arthritis, liver or lung diseases) but felt in the shoulder.
  • Muscle Strains:
    • Injury or inflammation of shoulder or upper arm muscles.
  • Labral Tears:
    • Cartilage injuries within the shoulder joint.
  • Nerve Compression or Injury:
    • Conditions affecting the brachial plexus or other nerves in the shoulder region.
  • Shoulder Instability:
    • Dislocation or subluxation of the shoulder joint.

How Can Physiotherapy Help with Shoulder Pain:

Physical therapy can help manage shoulder pain and aid in returning to normal everyday function. Our PTs are trained to provide relief by doing the following:

  • Laser Therapy and Ultrasound Therapy: Used for heating and promotes tissue healing.
  • Interferential Therapy: Stimulates the muscle and nerve fibers.
  • Shockwave Therapy: to relieve pain.
  • Exercise Therapy: Muscle Strengthening and Stretching and training to improve overall function.
  • Postural Training: for the best positions for weight bearing to reduce stress on the muscles and joints.
  • Education: Learning different techniques to perform daily activities even while being limited
  • Manual Therapy: Manual techniques such as trigger point release is beneficial in improving mobility and reduce pain.

Frozen Shoulder- Physiotherapy for Frozen Shoulder

Description/ Introduction

Adhesive Capsulitis aka “Frozen Shoulder” is a condition that is caused by the thickening of the shoulder capsule –a sheath that encases the joint of the shoulder, thus restricting movement. The main symptoms of frozen shoulder are joint pain and stiffness that worsen over time. The Physios at our clinics aim to combat Adhesive Capsulitis and its symptoms by using a variety of treatment techniques and modalities to provide lasting long-term relief.

Clinical Signs and Symptoms

Frozen Shoulder often presents with symptoms such as:

  • Sharp pull or pain in the middle of upper arm on sudden movements, like a flash of lightening 
  • Difficulty raising your arm sideways or forwards or carrying objects.
  • Difficulty putting the arm behind your back. 
  • Pain in mid-range of shoulder movement 
  • Pain in shoulder lasting for more than a few days.
  • Swelling or significant bruising around the shoulder or arm
  • Shoulder pain that occurs at night or at rest, also disrupting normal sleep patterns

1. Freezing Stage

  • Duration: Lasts approximately 2 to 9 months.
  • Characteristics:
    • Pain takes center stage.
    • Any shoulder movement triggers discomfort.
    • Gradual loss of shoulder mobility.
    • Simple tasks such as fastening a seatbelt or reaching for a cup becomes difficult.

2. Frozen Stage

  • Duration: Persists for about 4 to 12 months.
  • Characteristics:
    • Pain may ease, but stiffness intensifies.
    • The shoulder resembles a rusted hinge, resisting movement.
    • Everyday activities like putting on a coat, combing hair become impossibly difficult.
    • Nocturnal discomfort/pain that disrupts sleep.

3. Thawing Stage

  • Duration: Gradual improvement over 5 to 24 months.
  • Characteristics:
    • The shoulder cautiously thaws, like a winter morning yielding to the sun.
    • Movement becomes less painful.
    • Range of motion gradually returns.
    • Patients regain the ability to reach overhead and perform daily tasks.

How Can Physiotherapy Help Frozen Shoulder Patients

Physical Therapy for Frozen Shoulder focuses on the management of symptoms present and reduction of pain and increasing available range of motion. Physiotherapy can help patients achieve decrease in pain/discomfort, improvement in muscle strength, return to activities of daily living, etc.

Services provided by Us:

Our physiotherapists will assess the painful area and treat the symptoms with a combination of techniques, some are as follows:

Physical therapy can help manage shoulder pain and aid in returning to normal everyday function. Our PTs are trained to provide relief by doing the following:

  • Laser Therapy and Ultrasound Therapy: Used for heating and promotes tissue healing.
  • Interferential Therapy: Stimulates the muscle and nerve fibers.
  • Shockwave Therapy: to relieve pain.
  • Exercise Therapy: Muscle Strengthening and Stretching and training to improve overall function.
  • Postural Training: for the best positions for weight bearing to reduce stress on the muscles and joints.
  • Education: Learning different techniques to perform daily activities even while being limited
  • Manual Therapy: Manual techniques such as trigger point release is beneficial in improving mobility and reduce pain.

How to manage Acute Injuries and Pain

What happens during an injury?

When you get injured, the body’s natural response will be inflammation.  Signs and symptoms of acute inflammation will be swelling, redness, heat and pain.  Mainly caused by the increased blood flow associated with swelling.

Thus, initial management of an acute injury will be to reduce the inflammation and swelling.

How?

P.R.I.C.E.R.

P = Protect

R = Rest

I = Ice

C = Compression

E = Elevation

Protect

The injured area should be protected to prevent further injuries.  The injury can be protected with arm sling, braces, splint or taping and aids such as crutches can be used.

 Rest

Resting the injured area will prevent further injuries and also help start the healing process.  The injured area will usually be weak and more vulnerable to further injury.

Ice or cold therapy

Ice helps decrease blood flow to the injured area by constricting the blood vessel, thus minimise swelling / inflammation

Compression

Applying compression around the injured area helps minimize swelling by preventing the build-up of fluid.  Compression can also help relief pain by immobilizing and providing support to the area.  It should not be too tight that it interferes with blood flow.

Elevation

Elevation of the injured area (above the level of the heart) will allow fluid to drain away from the area.  With gravity, swelling or fluid can pool at the joints below.

Referral

Referral refers to consulting a Doctor or a Physiotherapist for further treatment.  Especially if you are unsure of the extend of injury and if the injury does not get better by 3 to 5 days.

PRICER should be administered within the first 48 to 76 hours after an injury.

Heel spur causing heel pain

A heel spur is a bony growth that forms under the heel bone, and it can cause sharp or nagging pain and inflammation in the heel and its surrounding areas. Heel spurs are often caused by overuse, wrong shoes, improper foot mechanics, and certain medical conditions such as plantar fasciitis.

Heel pain from a heel spur is typically felt in the bottom of the heel and can be accompanied by:

  • Sharp pain when standing or walking
  • Pain that is worse in the morning or after prolonged sitting
  • swelling or redness in the heel
  • bony protrusion that can be felt or seen on the heel

Treatment for heel pain from a heel spur may include:

  • Rest and ice: Applying ice to the affected area can help reduce pain and inflammation.
  • Stretching and exercises: Stretching the calf muscles and Achilles tendon and doing exercises to strengthen the muscles in the foot and leg can help improve flexibility and reduce stress on the heel.
  • Orthotics: Customised shoe insoles can help correct any improper foot mechanics that may be contributing to the heel spur.
  • Medications: Non-steroidal anti-inflammatory drugs (NSAIDs) can help to reduce pain and inflammation.
  • Physiotherapy: A physiotherapist can treat this using Laser, Ultrasound and Radial Shockwave therapy and  exercises to improve strength, flexibility, and range of motion.
  • Surgery: In some cases, surgery may be recommended to remove the spur, but it is usually considered as a last resort.

 It is important to consult with a healthcare professional to determine the underlying cause of heel pain and the appropriate course of treatment. Additionally, some lifestyle modifications such as switching to shoes with a cushioned heel, avoiding high-impact activities, and incorporating low-impact exercises like swimming, cycling or yoga can also be beneficial in managing heel pain from heel spur.

You may contact us if you need help with your heel pain.

 

Foot and Heel

Plantar fasciitis is felt as a pain around the heel and arch of the foot. It can be felt as a discomfort or sharp pain in the heel on weight bearing especially after a rest period. As a person gets older, the fascia becomes less elastic. The heel pad becomes thinner and loses the capacity to absorb as much shock. There may be some swelling, small tears or bruises in the plantar fascia with the pounding force on the heel. Plantar fasciitis can also be a result of overuse in activities such as long-distance running, basketball, ballet dancing or dance aerobics. It settles down quickly if treated early and given enough rest, but may become worse and  chronic if initial symptoms are ignored.

To reduce the pain of plantar fasciitis, try these self-care tips:

  • Give adequate rest to your feet. Avoid prolonged standing or high impact activities like running that cause repeated loading on the foot. If you need to stand for long time, then shift your weight from one foot to the other or use a footrest under the affected foot to offload it for a while.
  • Don’t walk barefoot,especially on hard surfaces, as this puts extra stress on the plantar fascia. It is advisable to wear soft heeled footwear or footwear with scooped out heels to avoid pressure on the heel.
  • Wear supportive shoes.Choose shoes with a low to moderate heel, supportive arches and good shock absorbency.
  • Avoid high heels especially when you need to walk long distances or stand for long periods of time. High heel shoes exert additional pressure on the inflamed fascia and lead to more heel pain.
  • Do not wear worn-out shoes.Replace old, tattered, non-supportive shoes. This is very important if you walk or run in these shoes. A good way to tell that your shoes need replacing is to look for thinned (worn) out areas on the sole of the shoe.
  • Apply ice: This can be done on the painful area three or four times a day, especially at the end of the day. Icing helps to reduce pain and inflammation. Icing can also be done with a frozen bottle of water rolled under the foot while sitting.
  • Massage: Self massage can be done by rolling a tennis ball under your foot while sitting. As mentioned above, a frozen water bottle can also be used.
  • Change your sport.Try a low-impact sport such as swimming or bicycling instead of walking or jogging while the plantar fascia is inflamed/painful.
  • Maintain a healthy weight. If you are overweight, then try to lose some weight. Extra weight can put extra stress on your plantar fascia.
  • Exercise before getting out of bed in the morning or after prolonged sitting(sit to stand): Plantar fasciitis pain is usually at its worst in these two situations. A good way to combat this is to perform circular movements at the ankle (clockwise and anticlockwise) and a few seated calf stretches before weight bearing on the feet.
  • Do your stretches.Simple home exercises can be done for plantar fasciitis. Perform this stretch when waking up, mid-day, and before bed. It is also very important to perform these stretches in the warm up and cool down phase of your exercise routine, even after you recover from plantar fasciitis pain. This will help to prevent any recurrences.