Plantar fasciitis (known also as the Policeman’s Heel syndrome) is the most common cause of pain in the heel.
If you are affected by Plantar Fasciitis, you will feel pain in the sole of the foot, in the region of the heel. This pain is sometimes described as a sensation of stabbing.
The pain tends to be particularly severe in the morning, when taking your first few steps after waking up, or in a more general way when you start using your feet after long periods of rest. It is therefore common for someone affected by the condition to experience the pain when standing up after sitting for an extended period of time.
This condition can become an annoyance for even day-to-day activities. The pain and stiffness of the foot may cause a patient to limp.
The pain can also be noticeable if you stand up for a long period of time, or if you perform an intense physical activity such as running or playing sports. The pain is not necessarily felt during the effort, but rather afterwards.
In most cases, patients are only affected in one foot. However, it is possible for both feet to be involved.
The plantar fascia is a broad band of fibrous tissue that runs along the sole of the foot from the heel to the base of the toes. With the calf muscle it creates a mechanism around the back of the heel that helps maintain the arch of your foot. The pain of plantar fasciitis is associated with damage, usually to the area where the tissue is attached to the heel bone. This damage may involve “micro-tears” and to a lesser degree inflammation.
There is normally no definitive underlying reason for plantar fasciitis, but it is quite often associated with having a tight calf muscle. There are also certain other factors putting you at greater risk of developing the syndrome, such as extended periods of standing (hence the name “policeman’s heel”). An additional risk factor is being overweight or obese, as this puts a lot of pressure on the heel in everyday life. In a related way, a sudden gain in body weight is strongly linked with the occurrence of plantar fasciitis. Runners who change their shoes or training routine may also develop plantar fasciitis.
Your specialist or podiatrist will talk to you about your symptoms and examine your foot and ankle. It may sometimes be necessary to conduct additional examinations to exclude other potential sources of pain and be sure of the diagnosis. These may include X-rays to assess the bones. An ultrasound or occasionally a MRI may also be needed, especially in chronic cases.
The vast majority of cases will respond to specific stretching treatments, both for the foot and for the calf. In most case, these stretches and other conservative treatments will be enough to treat the syndrome. However, in rare cases surgery may be an option if the initial treatments have not worked.
In most cases our specialist team will prescribe physiotherapy and use of special footwear.
Anti-inflammatory medication does not usually help reduce the pain. In order to reduce the length and intensity of the pain, our team will prescribe physiotherapy exercises that stretch the plantar fascia, the tissue affected by the condition, as well as the surrounding tissues and muscles. You may also be advised to wear cushions or insoles in your shoes to provide extra support to your affected foot.
In most cases, this type of treatment will cure the pain within weeks to a few months.
In less common cases where the type of treatment described above does not work after six months, our specialist may recommend surgery. This is generally considered as a last resort and is only recommended in about one case out of twenty. The procedure is minimally invasive, and involves stretching the tightest part of the calf muscle behind the knee. The surgery is without general anaesthesia and recovery is usually rapid.