ARE YOU SUFFERING FROM HEEL PAIN

Now a days  heel or foot pain is  most common  cause of painful  Lifestyle.  The  heel  pain occurs  due to no of factors but the most  common cause  of  heel pain  is planter  fascitis. So here  I am describing  all about  planter  facilities. 

PLANTER FASCITIS 

WHAT IS  PLANTER  FASCIA  :-

"The  thick  fibrous   deep  fascia  covering  the  sole  is  called  planter  fascia  . The  main function  of  planter  fascia  is  to  protect  deeper  structures  during  weight  bearing  As   during  walking  , Runing  and  jumping. "

PLANTER  FACILITIES :-

"Inflammation  of   planter  fascia  due  to  repeated  sustained  stress of  weight bearing  during  walking  ,  Runing  and   jumping  . Over  a  number  of  years  it cause  microtraumas  to  planter fascia  leads to  pain and  Inflammation. "

ETIOLOGY :- 

• Due to  repeated  sustained  stress  on  planter fascia  as during  weight bearing. 
• Most  commonly  occurs  in  policemen due  to over  stretching  of  planter  fascia. 
• It also occurs  in marathons  and sportmen. 
• It often  occurs  in  people  with  inadequate  shoes  wearing  habits. 
  
  

1. PATHOGENESIS :-
2. Long   term  repeated   sustained stress on planter fascia. 
3.  Microtrauma  to  fascia  over  a  number  of  years. 
4. Cause  Inflammation  of planter  fascia. 
5. Leads  to  heel and sole  pain. 

RISK FACTORS :- 

• Overweighted   peoples. 
• Women's   wearing   high  heels. 
• Patients  suffering  from gout  , flat  foot  , Diabetis  ,or  any other  inflammatory  conditions   and  patient  with Rheumatoid  arthritis. .

EPIDEMIOLOGY :- 

• Approximately  2 million  people  in United  State  suffering  from  planter   fascitis. 
• Females  affected  more  than male. 
• Prevalance  of  planter fascitis  is higher in those aged 45 to 64  year.

CLINICAL  PRESENTATION  :-

• Patient  complains   of  heel and  sole  pain .
• Patient  have   complain  that his pain aggravates   in morning  and  once  he  starts  walking  his pain get resolve. 
• Patient  feels  difficulty  in  barefoot  walking.

ON  EXAMINATION :- 

During  examination  the  therapist  founds  a tenderness over  medial  side  of  the  calcaneum. 

Tenderness  also presents  on the  insertion  point of  planter  fascia  .

INVESTIGATION:- 

Plain  X- Ray  :-  For   bone  spare. 

OTHER  TESTS  Involves   blood  test  for  other  conditions  related  to  planter  fascitis  like  gout  ,  RA  ,  Diabetis  etc. 

TREATMENT :-

CONSERVATIVE TREATMENT :-

• NSAIDS. 
• LOCAL  INJECTION  OF  STEROIDS. 
• Footwear  correction  and  wearing  heel  cushions like  MCR footwear. 

SURGICAL  TREATMENT :-

• Surgical  release  of  planter  fascia  through  proximal  medial  longitudinal  arch  . 

PHYSIOTHERAPY  MANAGEMENT  :-

GOALS  :-

•  Pain relief  .
• Improve  Functional  .

TREATMENT :-

MODALITIES  :- 

• US  therapy   AND  CRYOTHERAPY  .

OTHER :- 

•  Stretching  of  calf    muscles  
• Planter fascia  release. 
• Taping  of   foot .
• Splints
• Arch  support  and  heel pads.
  

ADVICE :-

• Maintain   a healthy  weight  .
• Modify  footwear :-  Choose  supportive  shoes  with  low  to moderate  heel  ,thick   soles, good arch, and  extra cushions, .
• Don't  walk  barefoot  .
• Change  or  modify  the  sport  until  the  condition   will  improve  .
• Apply  ice.
• Perform  self  stretching  exercices. 

The  following  exercises  should  perform :-

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