Monthly Archives: October 2019

Heel Pain Management Pathway

Heel Pain Management

Heel pain can be unpredictable and occasionally problematic to resolve. So we teamed up with Healthy Step to produce a heel pain pathway to pain free heels.

The HeelFixKit is the most innovative and cost effective approach available in the management and treatment of heel pain, plantar fasciitis and heel spurs. The HeelFixKit contains specially designed Insoles, Therapy Balls, Heel Tape & Heel Cups. Developed by a British Musculoskeletal Podiatrist, Andy Horwood, the pack is designed to allow you to treat your heel yourself and make dramatic improvements in just six weeks.

HeelFixKit for heel pain

By combining insoles, taping, stretching and strengthening the foot, a treatment programme is initiated that treats the heel pain holistically. The treatment regime not only helps settle the pain but also prevent the re-occurrence of heel pain, and its all achieved at home. the kit is £14.95 ex vat for trade and RRP: £34.95.

View HeelFixKit on DLT

How to make the most of your HeelFixKit

The heel fix kit comes with an exercise information sheet, as the exercises are essential to improving the pain and returning to activity.

Heel Pain Pathway – Help your patient with their pain with: 

• Downloadable heel pain pathway flow chart
• Exercise Videos to share on social media
• Downloadable heel pain sheet

Below is a printable self-help flow chart for your patients to help support their heel pain.
Print the large version here: A2-Heel-Pain-Pathway

Heel Pain Pathway Download

See the videos below for exercises that you can share and send to your patients.

Foot Therapy Ball –
Simple exercises to help strengthen your feet:

Stair calf exercise for non-insertional achilles tendinopathy.

An easy 3 step exercise to help strengthen your feet

Your patient can use this handy Pain Sheet to reassess their pain level every two weeks while following the advice on this pathway below. Print the large version here 32-Week-Pain-scale-1

Heel Pain Sheet

View HeelFixKit on DLT

 

Plantar Fascial Groove

ICB Lower limb biomechanics

Arch pain when wearing orthotics can be problematic as it often encourages patients to ‘give up’ on orthotic therapy.

The Plantar Fascia is a fibrous tissue that does not exhibit the capacity to stretch or elongate and so often the fascia presses onto the arch of the orthotic causing discomfort.

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The fascia assists in maintaining the longitudinal arch shape, however, can be an issue when it presents as a short fascia or excessively protruding fascia.

Image show Plantar fascial drop occurring at the 1st MTPJ performs the windlass mechanism during toe off phase of gait.

Inflammation and tearing at the heel bone

A tight fascia can also contribute to plantar fasciitis and heel spur syndrome due to the tension on the attachment at the calcaneus.

A Plantar fascial groove can be used when the plantar fascia is very tight or the patient indicates that the arch of the orthotic is causing pressure in the arch area.

Fascia Position

Generally the plantar fascia position on the orthotic device is located approximately 1 cm lateral to the medial boarder of the orthotic device.

The ICB orthotic can be easily modified using a heat gun to heat the area to be deflected.

ICB Heat Gun

The groove can be made using metal scissors or another similar item.

ICB Orthotic

When making the groove ensure that the heat is applied only to the plantar fascia position on the orthotic device to reduce any unwanted distortion of the EVA material.

For a more permanent solution the groove can be placed into the orthotic device using either a bench grinder or Dremel hand grinder.

ICB Orthotic For Heel Pain

The groove is created 1 cm from the medial aspect and runs the length of the arch of the orthotic device.

If the patient is suffering significant pain we advise the following step by step procedure to pain relief.

The first step would be to place a plantar fascial groove as this will allow the fascia a plantar drop and take pressure off the fascia.

Grind Orthotic

If pain persists due to the arch collapsing on the arch of the orthotic use a bilateral Rearfoot Inversion addition which will reduce elongation of the fascia by inverting the rearfoot .

ICB Orthotic Rearfoot Varus

If further adjustment is required a 1st Ray cut away or 1st MPTJ deflection will be required to reduce tension on the fascia.

Both 2/3 and Full Length deflections work effectively in reducing the tension on the fascia.

ICB orthotic

Orthotic therapy is one in which some minor adjustment may be needed when treating patients.

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