This is the most common biomechanical problem presenting to podiatrists. The Plantar Fascia is a ligament that extends over the full length of the plantar surface of the foot. (see diagram). This ligament is best likened to a piece of rope rather than an elastic band. Poor biomechanical function can result in inflammation and pain anywhere along its length, most commonly in the arch and insertion site at the heel.
Self treatment may include rest, stretches, massage and anti inflammatories.
For short term relief I find the application of a rigid supportive strapping to be extremely reliable. This strapping does need to be kept dry and removed immediately if the area gets itchy as this may indicate sensitivity to the tape or a fungal skin problem.
Long term treatment focuses on functional orthotic devices and footwear advice.
Other treatments may include shock wave therapy or dry needling. Your GP may inject cortisone around the heel insertion site.
A standard podiatry consultation will involve the cutting and filing of toe nails and removal of excessive thick skin and corns. Chronic toe irritation, due to the involuted shape of some nails, can be relieved by removing slivers from the edges of the nail. Minor foot deformities may result in areas of increased pressure and the formation of painful thick skin deposits and corns. The skin and corns are removed during the consultation, but these areas of pressure may be offloaded through the fabrication of deflective padding or devices, which will keep the patient much more comfortable between consultations.
Podiatrists are not foot massagers. We have no education or qualification in foot massage. However, at the end of your consultation an emollient cream is applied to moisturise the skin, and a short foot massage is given in the application of this cream. If this part of the consultation is particularly important to you, please mention this to the podiatrist.
Half of all hospital admissions for diabetics are due to foot problems. Long term Diabetes results in degeneration of peripheral nerve endings and blood vessels. Your feet are the furthest point from both your brain and your heart and are therefore the most vulnerable body part to these changes. These changes occur gradually, and your level of risk for developing foot problems needs to be monitored. It is therefore important that all diabetics have at least an annual assessment of their foot risk status by a podiatrist. This assessment will include a basic neurological and vascular assessment of your feet and a close examination of your feet for any areas of deformity that may result in wound formation. Appropriate lifestyle and footwear advice will be given depending on your level of assessed risk. Prevention of complications is the goal of these regular assessment s and advice.