Category Archives: Plantar Fasciitis

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

 

Hapla Tape For Plantar Fasciitis

hapla

Before applying tape it is important
to remember to round the corners
of each piece.
Rounding the corners prevents the
tape from catching on clothes and
peeling back which may reduce the
time the tape will stay adhered to the
patient.
How to cut hapla tape
Directions for use – Rounding Corners
1 Plantar Fasciitis - Hapla Wave Tape 2 Plantar Fasciitis - Hapla Wave Tape

Patient will be experiencing pain either on the central or medial portion of the heel. Ensure the foot is in a dorsiflexed position.

Cut a full width piece of tape long enough to go from the metatarsal heads up to the mid calf.

 3 Plantar Fasciitis - Hapla Wave Tape 4 Plantar Fasciitis - Hapla Wave Tape

Tear and remove the backing paper from one end of the tape.

Place an anchor point at the metatarsal heads applying zero stretch.

5 Plantar Fasciitis - Hapla Wave Tape 6 Plantar Fasciitis - Hapla Wave Tape

Remove the first part of the remaining backing paper.

Apply 50% stretch to the tape.

7 Plantar Fasciitis - Hapla Wave Tape 8 Plantar Fasciitis - Hapla Wave Tape

Apply the tape down to the heel.

At the heel reduce the stretch down to 25%.

9 Plantar Fasciitis - Hapla Wave Tape 10 Plantar Fasciitis - Hapla Wave Tape

Apply tape to the Achilles.

Place an anchor point with zero stretch on the achilles tendon and apply friction to all areas of the applied tape.

11 Plantar Fasciitis - Hapla Wave Tape 12 Plantar Fasciitis - Hapla Wave Tape

Cut a six inch length of tape, tear and remove the central part of the backing
paper.

Apply a 50% stretch across the site of pain. Make sure you apply each end (anchor points) with zero stretch.

13 Plantar Fasciitis - Hapla Wave Tape 14 Plantar Fasciitis - Hapla Wave Tape

Apply another six inch length of tape at a slightly more oblique angle to the first
across the site of the pain.

Apply friction to all areas of the applied tape and ensure patient is comfortable.

15 Plantar Fasciitis - Hapla Wave Tape

Alternatively, if they are able, you could put your patient into this position to ensure dorsiflexion of the foot.

 


Treating Plantar Fasciitis

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Plantar Fasciitis (PF) is a degenerative syndrome of the plantar fascia resulting from repeated trauma at its origin at the calcaneus1.

It is reported to be the most common cause of inferior heel pain in adults2.

Plantar fasciitis is also known as painful heel syndrome, heel spur syndrome3, runner’s heel, policemen’s heel, subcalcaneal pain, calcaneodynia and calcancal periostitis.

Treating the causative factors of plantar fasciitis is key to designing a treatment for your patient.Using the point of pain test will indicate if the pain is Lateral, Central or Medial.Valmassey refers to plantar fasciitis as affecting both pes planus and pes cavus foot types4 with opinion being that different pain regions may be suffered depending upon the foot structure (watch video).Generally speaking the following often applies:

Lateral Heel Pain is often associated with an uncorrected forefoot valgus and pes cavus foot type.

Central Heel Pain often indicates a forefoot valgus is present, in addition to rearfoot pronation.

• Medial Heel Pain generally indicates the patient will exhibit excessive rearfoot pronation.

ICB-HeelSpur-DIG_web

 Point of Pain TEST

Drawing-Plantafaciitis-test-1-web

In each case, treatment will involve prescribing an orthotic device to control rearfoot pronation and provide biomechanical correction. In the cases of Central and Medial pain, a heel deflection (referred to as a ‘horseshoe deflection’) in the orthotic can also assist by relieving pressure on the attachment. Low Dye Strapping can be used to provide short term pain relief, as it mimics the support and control offered by an orthotic device.
Shockwave therapy has also been used to some effect in breaking up scar tissue. Anti-inflammatory medications, massage and surgery are generally less successful in the long term treatment of Plantar Fasciitis.

TREATMENT SOLUTION: ICB MOULDING ORTHOTICS

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ICB Sports Orthotics  have an intrinsic 5° rearfoot varus angle to assist in controlling rearfoot pronation, and a horse shoe deflection making them ideal for treatment of Plantar Fasciitis.

VIEW ICB ORTHOTICS

References:
1. Cornwall MW. McPoil TG., Plantar fasciitis : Etiology and Treatment.  Orthopaedic Sports Physiotherapy (1999);29:756-76
2. Singh D. Angel J. Becky G. Trevino SG.,Fortnightly review. Plantar fasciitis. BMJ (1997):315:172-17.S.
3. Lemont H, Ammiiati KM, Usen N. Plantar Fasciitis: A Degenerative Process (fasciosis)
Without Inflammation. American Journal Podiatric Medicine Assoc (2003); 93:234-237
4. R.L. Valmassey, Clinical Biomechanics of the Lower Extremities. (1996) p76