Plantar heel pain is one of the most common musculoskeletal conditions that is seen at the specialist foot clinic on Sheikh Zayed Road, Dubai Podiatry Centre. It can cause significant pain, especially in the mornings and can cause significant impact on walking (causing a limp), productivity and general quality of life.
Chief Podiatrist Michelle Champlin explains, “Alleviating plantar fasciitis is one of the most rewarding treatments that we provide – from identifying any underlying biomechanical cause, to making just the right bespoke custom orthotics for the patient to alleviate it. It is fabulous to alleviate pain that patients may have been suffering with for weeks, months or even years and who may have tried all sorts of therapies to no avail.”
Patients have frequently tried interventions such as plantar arch strapping, over-the-counter arch supports and heel cups before they come to see Dubai Podiatry Centre. The chronic pain can be debilitating and affect everything from your ability to walk around the mall or stand at work.
How Do The Biomechanics Of Plantar Heel Pain Relate To Foot Orthotic Therapy?
Heel pain can have a number of causes including plantar fasciitis, subcalcaneal bursitis, neuritis, medial arch pain, subcalcaneal pain, stone bruise, calcaneal periostitis, subcalcaneal spur or heel bone fracture. However, the majority of patients exhibiting plantar heel pain have pathology related to injury of the plantar fascia i.e. plantar fasciitis is the most common cause of heel pain.
There are many risk factors for plantar heel pain, including increased body mass index (BMI), limited ankle joint dorsiflexion (e.g. ankle equinus), heel spur, leg length discrepancy, diminished heel fatty pad thickness, pes planus (flat feet), pes cavus (high arches), excess overpronation and hallux limitus or hallux rigidus (reduced range of movement in the big toe joint).
The plantar fascia connects your heel to your forefoot, providing support like the bottom beam of a roof truss
What Are The Potential Biomechanical Effects Of Foot Orthotics On The Plantar Fascia?
The plantar fascia is a very strong but non-stretchy connective tissue between your heel and forefoot, also known as the plantar aponeurosis. It acts almost like an ‘emergency band’ which carries the bulk of load during standing and walking, maintaining the structural integrity of the arch of the foot when the foot’s other tendons, ligaments and muscles do not support foot posture as they should.
At Dubai Podiatry Centre, the Podiatrists think more from a structural engineering standpoint, comparing foot structure to both a structured beam as well as a truss, stabilized by a “tie,” which is the plantar fascia. When weight-bearing, the plantar fascia prevents the ends of the arch from elongating. This mechanism helps explain the ‘biomechanics’ of using arch supporting custom orthotics to treat plantar fasciitis.
A study by Kogler et al found that orthotics significantly reduced strain in the plantar fascia. However, it is important to note that only those orthoses that had significant contour under the “apical” portion of the arch (i.e. talonavicular joint) provide benefit, which is one of the reasons why Dubai Podiatry Centre provides custom corrective orthotics made by the Podiatrists in their in-house lab, from a mould of the patient’s feet. This ensures an exact shape is tailor made with the precise prescription applied to correct foot posture as required – no two feet are the same and different prescriptions, just like braces for the teeth, are required for each patient.
Foot orthotics provide immediate, intermediate and long-term relief of plantar heel pain with significant pain relief normally felt within the first six weeks.