Foot pain in the morning and not going away?
Tommy Conway, Director and Head Physiotherapist at OneHEALTH
You wake up, throw off the blankets, get your feet on the ground and look forward to your day. Well that’s how it used to be! Now you wake up, throw off the blankets, hesitate when placing foot on the ground and slowly limp down the stairs. Your foot is stinging with pain, it's in your heel and travels along the bottom of your arch. It feels red hot and sore to touch. You're no longer able to walk without breaking into a full on limp, ringing someone to come collect you as you know you won’t make it home. You have tried the magic golf ball, rolling the arch of your foot day and night, yes it works a little but doesn’t stick. Now you have thrown in using a half filled water bottle, frozen, great for easing your pain but the relief doesn’t last, back to limping out of bed the next morning. The condition you have is plantar fasciitis, a very painful, long and draining condition. I know it might not be too bad now but it will become a daily pain because you're breaking down a very important component of your foot, read on. You might be suffering for months, you might be suffering for years, read on. Your foot is a very important structure and you have to get this condition better. If you don’t it affects so many other structures, knee, hip and spine. All treatments aren't the same, at the early stages you might need some mobility work and hands on treatment and you will improve. If you have this condition for a long time, you might need a helping hand to bring home with you, to keep you aligned.
What is it?
The plantar fascia is a tight band of rope like tissue that attaches from your heel to your toes under your foot. Under normal circumstances your plantar fascia acts like a shock-absorbing bowstring supporting the arch in your foot. However, if tension and stress on that bowstring becomes too great, degeneration of collagen fibres can arise in the fascia. Repetitive stretching and shearing motions can cause the fascia to become irritated or inflamed. It is important to note this can happen to people with all different types and shapes of foot arches. There is a misconception out there that this only happens to people with flat feet or fallen arches. This is wholly untrue and it affects people with high arches and low arches.
How does it happen?
There are three main causes for why you are suffering with plantar fasciitis.
1: Calf length: See in the below picture, where the calf muscle attaches to your heel. If you have a calf muscle that is shortened, it will change the position of your heel bone. This is important because when you take a step your heel has to hit the ground in the right place, if it does not, it will become overworked, inflamed and irritated. This calf length issue can also be caused by having a high arched or low arched foot.
2: Arch length: High arched foot. When you have a high arched foot, your plantar fascia tissue is shortened. This means that if you can stretch this tissue and get some treatment it should benefit the injury. The question is do you have a foot that looks like? See picture 2.
3: Foot strength: Low arch. When you have a low arched foot your plantar fascia is lengthened and stretched out. It does not need more stretching it needs the opposite, strengthening. Again,The question is do you have a foot that looks like? See picture 2.
How to get rid of it?
1. Stretching and Strengthening: As I have outlined from the very beginning, you might need some mobility work and hands on treatment to improve. The key difference here is doing the right stretches and strengthening work. Most are given a generic programme of roll the ball and icing but this makes no sense. As you may be someone with an inflamed foot that has a low arch or a high arch then you need two different treatment plans. Your treatment plan will also have to take into consideration the amount of time you have to spare and also your consistency in doing your rehabilitation. One thing I have learned about foot conditions, is they take a long time to heal and if you have your condition over six months. It will take three - six months to improve it.
2: Orthotics: If your problem is ongoing for three to six months, I would scan your foot and do a full foot walking analysis. I would want to know how your heel is striking the ground and what type of foot you have? If I feel that I can resolve someone’s Plantar fascia issue by using hands on techniques and exercise routines, I will. At times I know that because of your job and time on your feet, I need a helping hand to keep you aligned and stop the tissue becoming inflamed. Orthotics work by making sure your high or low arched foot is in the best position throughout the day. You need to wear them alot, not just for when you go walking. They make a change because when you swing your legs out of bed in the morning, you search for your footwear with the orthotics in and you leave them on all day until you see improvement in your foot.
So to conclude, if you want to be able to jump out of bed with no limp, walk longer distances and not have to roll the ball day and night, you need to sort this out. Plantar Fasciitis does not go away on its own. It changes the way you walk, the way your heel hits the ground. Now you have a sore knee, hip with plantar fasciitis hiding underneath, causing it all. Oh that’s ringing a bell for you now, you can remember the time you had a sore foot, it went, but now you have all these other issues, on the same side! It won't go away on it’s own because it is a clear sign of damage. Do not hesitate to get it sorted, The first step I would take is to find out what foot type you have? Once I examine your foot then I would know if you needed to be stretched, strengthened or put in an orthotic. I hope this helps. Tommy.
You can email me [email protected] with any questions.