bondi junction 9386 5400 st ives 9386 5400

heel pain management

Are the first few steps out of bed in the morning painful for you?
Do you feel you would be better walking on your toes?
Does it feel okay for a short while but then gets worse as the day goes on?
Have you been told that there is nothing you can do…

These are common complaints we hear at the footinjuryclinic!

Treating Plantar Fasciitis Bondi Junction and St IvesPain first thing in the morning is a very common problem and occurs most often in people suffering from plantar fasciitis and other types of heel pain. The heel pain usually occurs when you first get out of bed. It can last from just a minute or two to up to half an hour. The pain may also occur after sitting for a period of time.

Morning heel pain is a sign that you have inflammation occurring in your heel. Our goal when treating you is to determine the exact cause of this pain and then develop a treatment plan to not only relieve your pain, but to prevent the problem from returning.

Our treatment plans are based on ongoing reviews of medical literature and our own 25 years of experience. We can usually treat even the most chronic cases of heel pain – even if you have seen many other practitioners. Almost all heel pain can be treated conservatively and surgery is almost never necessary.

What exactly causes heel pain in the morning?

The plantar fascia is a strong ligament that runs the length of your foot from the heel bone to the toes. Although it is strong, it is not very elastic, so repeated movements, such as running, can overstretch it and partially tear or pull it away from the heel bone. The plantar fascia can also overstretch or tear at the arch.

Usually, the symptoms begin gradually, but after several weeks, the pain gets worse and does not diminish. Generally, there is no swelling or bruising in the area. However, you may feel tenderness when you apply deep pressure to the heel pad or the arch.

Plantar fasciitis and many other heel conditions are caused by damage to the tissue that connects into the heel or mid foot. This damage causes inflammation.

When you walk around during the day, the act of walking with muscles contracting and pressure from the ground pressing on the heel acts like a massage and prevents inflammation from building up in the heel. But if you lay down at night or sit down for a while during the day, you stop doing those actions that prevent the build-up of inflammation. The inflammation builds up and then when you go to stand up again, you have a sharp pain in your heel due to the extra inflammatory fluid in the area. You then walk around for a few minutes, the inflammatory fluid is pumped out of the area and you feel better – at least for a while.

In normal functioning of the heel, the plantar fascia acts as a shock absorber and support mechanism for the arch of the foot. During gait, or movement, the plantar fascia acts like a spring which winds and unwinds to conserve energy and provide propulsion. Tension increases while the foot is on the ground to store the energy and is then released during toe-off to help with acceleration.

Plantar fasciitis literally means inflammation of the plantar fascia, but most cases are more degenerative changes rather than inflammatory ones. A new term being used to accurately describe the condition is plantar fasciosis. In most cases the pain is on the under surface of the foot at the junction of the plantar fascia and the heel bone know as the calcaneous. The condition accounts for about 10% of runner related injuries and is twice as predominant in women than in men. Because of this high incidence in runners, microtrauma from repeated stress is believed to be the primary base cause.

Plantar fasciitis may go away on its own, with rest, but it may take several months or longer to resolve completely. There is treatment to help you recover faster.

Heel Pain Bondi Junction and St Ives Management of Plantar Fasciitis near Bondi Junction and St Ives Management of Heel Pain near Bondi Junction and St Ives

treatment of morning heel pain

Don’t live with morning heel pain. We can diagnose your exact problem, provide treatments that provide rapid relief of pain and then teach you how to prevent the problem from returning.

symptoms

Podiatrists who treat Plantar Fasciitis near Bondi Junction and St Ives

    Plantar fasciitis causes a number of symptoms that include:

  • Sharp, stabbing pain on the bottom or side of the heel or in the arch of the foot.
  • Pain that is worse in the morning or after any period of inactivity. As you begin to move around, the pain level usually improves.
  • Pain that gets worse after a prolonged period of standing, walking, or running.
  • Pain that can last for several weeks or months and can range from mild to severe.

screening and diagnosis

We usually diagnose plantar fasciitis by asking you about your symptoms and physically examining your foot. At the footinjuryclinic we have state of the art video gait analysis and pressure fluoro scopes which we use in aiding our diagnosis. We may order an imaging study, such as an X-ray, if we suspect that your symptoms may be caused by another condition, such as a stress fracture, but this is rare.

who gets heel pain

There are a number of factors that can increase the likelihood that you will develop plantar fasciitis including:

  • Excess weight
  • Specific sports activities
    Activities that put significant pressure on your foot and require it to stretch repeatedly increase your risk. These activities include running, walking long distances, jumping, tennis, beach running and aerobics.
  • Age
    Middle-aged people, between 40 and 60 years old are more likely to develop plantar fasciitis.
  • Abnormal foot mechanics
    Flat feet or high arches can affect the way that pressure is distributed across your foot ,placing additional stress on the plantar fascia.
  • Tight Achilles tendon and excessive flattening of your feet (pronation)
    The Achilles tendon links the calf muscle to the back of the heel. A tight calf muscle and Achilles tendon can cause your foot to flatten further, placing additional stress on the plantar fascia.
  • Standing all day
    Standing or walking on hard floors for a long time increases the load on your plantar fascia.
  • Inadequate footwear
    Excessively flat shoes that do not support your arch leave the plantar fascia unprotected. A shoe with a medium heel can heighten the arch and decrease stress on the plantar fascia.
  • Sudden change in activity
    Beginning an exercise program , such as high-impact aerobics, after a period of inactivity can overload the structures in your foot. Similarly, changing your running surface from grass to road can affect your plantar fascia.

heel spurs

Very often a heel spur is associated with or spoken about as the same injury as plantar fasciitis. A heel spur is a boney growth under the heel bone at the attachment of the “arch muscle”. For a heel spur to develop, the underlying cause has to have been present for many years. Biomechanical anomalies with the foot are often the base cause but the presence of a spur does not indicate the severity of your heel pain and often the worst cases of plantar fasciitis have no spur formation.

prevention

Aiding Heel Pain Treatment near Bondi Junction + St IvesThere are a number of things you can do to protect your feet and prevent injury to your plantar fascia:

  • Wear supportive shoes
    We recommend running shoes or “pro” walking shoes. It’s a good idea to wear these when you are running or walking a long distance or when you will be on your feet for an extended period of time.
  • Wear shoes with slightly higher heels
    A moderate heel can shorten the arch, reduce stress on the plantar fascia, and lead to a reduction of pain. At the footinjuryclinic we recommend a ladies heel of around 2.5cm.
  • Do not walk barefoot
    Even at home when suffering from plantar fasciitis.
  • Lose weight
    Talk to your personal doctor, trainer or dietician.
  • Stretch
    It is important to warm up before you exercise. Stretching your calf muscles will help protect your Achilles tendon, which in turn will ensure that your feet land correctly during walking and running.

treatment

It may take 3 to 12 months for your plantar fascia to heal completely. We recommend using a number of treatment approaches simultaneously, home and medical. It is important that you continue treatment until you have been pain-free for at least 3 months.

  • Rest
    Rest your foot for 2 to 6 weeks. Stand, walk, or run less.
  • Change your activities
    While your foot is resting, try exercise that does not stretch your arch, like swimming or cycling.
  • Choose footwear that supports your foot
    Shoes and devices that support your foot can help protect your plantar fascia and allow it to heal. We recommend a combination of the following footwear and devices:
    – Supportive shoes

    Wear shoes with good arch and heel support. A higher heel may also help. Avoid standing or walking barefoot or in unsupportive shoes like slippers or sandals.– Arch supports
    Wearing arch supports inside your shoes reduces strain on the plantar fascia. We recommend the Orthema EVA molded orthoses.– Use over-the-counter pain relievers
    Over-the-counter (OTC) nonsteroidal anti-inflammatory drugs (NSAIDs), such as Ibuprofen or Volatren can help manage your pain or discomfort. OTC NSAIDs are effective pain relievers that can be used if you have no health conditions that prevent you from taking them. Even though you do not need a prescription for OTC NSAIDs, you should be careful to consult the package so that you take the correct dose.

    Be aware that OTC NSAIDs can interact with other medicines you may be taking and cause problems for people with various medical conditions. These medications can help reduce the pain while your plantar fascia is healing. If they do not seem to be helping, do not continue taking them.

    If you have a complex medical condition, are pregnant or trying to get pregnant, or have been taking OTC NSAIDs and they do not relieve your symptoms, please let us know so that we can recommend an alternative.

    Anti-inflammatory medication (if tolerated) and natural substances such as arnica may help reduce your pain and swelling. However, it is best to avoid anti-inflammatory drugs during the initial 48 to 72 hours when they may encourage additional bleeding. Most people can tolerate paracetamol as a pain reducing medication.

  • ice your foot
    Massage the painful area with ice for 2 to 10 minutes , several times a day. A frozen water bottle can provide you with a ice foot roller that can simultaneously provide you with some gentle plantar fascia massage.
  • stretch
    Stretch your calf muscles and Achilles tendon. It’s important to stretch before and after you exercise. We recommend that you warm up a little and then stretch at the beginning of your exercise program, if possible.

footinjuryclinic recommended stretches FIC Stretches 2013

  • strapping/taping
    Low Dye taping for the feet that can be performed by your podiatrist and taught to self application.
  • nonsurgical medical treatments
    If the home treatment methods do not completely resolve your symptoms , we may recommend additional treatments that may include:
    Custom orthotic insoles

    We recommend custom orthotic inserts that are made specifically for your foot. We use Orthema CAD/CAM digital technology in order to create these inserts. 

          – Physiotherapy

          – Cortisone injections

We may recommend a cortisone injection to reduce inflammation and accompanying pain. Cortisone is a steroid that mimics natural hormones that reduce inflammation.

our promise to you

The footinjuryclinic, its podiatrists and support staff are passionate about our specialty. We are dedicated to exceeding your expectations in helping you restore and maintain your health quickly, with cost effective and evidence-based treatment.
We achieve this goal through comprehensive examination, accurate diagnosis, clear explanation, and individually tailored, multi-faceted treatments.
Your wellbeing is very important to us at the footinjuryclinic . We are serious about feet and promise to discuss your foot care in a language you will understand, using technology and skills that compliment your care.

referrals and payment

No referrals are required unless you fall under DVA or work cover.


  • Private health funds
    Podiatry is a registered and regulated health profession with private health funds providing cover for some podiatry services on their ancillary tables. Please speak to your provider to establish what codes and how much will be covered for podiatry. Read More...

our locations

bondi junction
18/108 Ebley Street
Bondi Junction, NSW 2022
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t   02 9386 5400
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st ives
7/219 Mona Vale Road,
St Ives, NSW, 2075
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t   02 9440 4600
email us today