If you are experiencing foot pain, Apex Manual Therapy can relieve the discomfort by identifying the root cause to effectively and efficiently treat the problem. Whether you’re suffering through ankle pain from a sprain, shooting pain in the foot, pain in the arch of the foot or recovering from a surgery, we can help.
Our advanced physical therapists have obtained the highest level of orthopedic physical therapy training and are recognized as Fellows of the American Academy of Orthopedic Manual Physical Therapy (FAAOMPT). This educational achievement is beyond the doctorate level and guarantees gold standard care for musculoskeletal conditions. To date, there are around 1,800 fellows in America.
At Apex Manual Therapy each visit is spent entirely one-on-one with a fellow, to thoroughly assess foot problems and provide the very best foot pain treatment. We guarantee you’ll see the difference in our approach and your results.
If you’re in the greater Austin or Pflugerville, Texas, area, schedule a free consultation with our advanced therapists.
Why Foot and Heel Pain is Common
The foot is the first thing to hit the ground when walking. It must be adaptable enough to absorb the impact of varying terrains yet rigid enough to propel you forward. The foot must also be able to supinate and pronate during walking to properly distribute forces. (see photo below)
When the mechanics of the foot are in dysfunction, you may experience ball of foot pain, ankle pain, shooting pain in foot or pain in the heel of the foot. Developing a condition known as plantar fasciopathy is also possible.
Plantar Fasciopathy (Plantar Fasciitis)
Plantar fasciopathy, more commonly known as plantar fasciitis, is considered one of the most common foot abnormalities. It affects up to 2 million Americans each year and the chief complaint associated with the condition is heel pain.
The term plantar fasciitis implies inflammation, and studies show no signs of inflammation, therefore the name was changed to plantar fasciopathy.
The cause of plantar fasciopathy remains unclear. It is generally accepted that the cause is a mechanical dysfunction resulting in an overload of the plantar fascia, the ligament that connects the toes to the heel bone. A mechanical dysfunction refers to the abnormal movement and use of the foot. If the foot is not moving correctly and properly absorbing and distributing loads, the plantar fascia can become overexerted and cause pain in the heel of the foot.
Plantar Fasciopathy Contributing Factors
Anatomical: obesity, pes planus (collapse or fallen arches) or pes cavas (high arches)
Biomechanical Faults: overpronation, limited ankle mobility, calf and hamstring restrictions, poor performance of foot and ankle muscles
Environmental: poor alignment, deconditioned, hard surfaces, prolonged standing, inadequate movement, poor footwear
Systemic: When plantar fasciopathy occurs in both feet it is associated with rheumatoid arthritis, system erythematosus, and gout.
Population Most Affected by Plantar Fasciopathy
Common in athletes and sedentary individuals, typically 40-60 years old. This type of foot pain can occur in younger populations, women slightly more than men.
Patient Symptoms and Complaints
Severe pain in the heel. After rest periods pain subsides but is aggravated by long periods of weight-bearing. Heel spurs are also associated with plantar fasciopathy but are not the cause of pain. Heel spurs have also been found in people without heel pain.
Diagnosis of Plantar Fasciopathy
Diagnosis of plantar fasciopathy is based on a clinical examination with careful palpation of the structures involved. Your therapist will also discuss the reported symptoms and thoroughly review the lower body mechanics.
Diagnostic Imaging
Using x-ray to locate heel spurs, ultrasound for thickened fascia and “hot” bone scans are common diagnostic tools for patients with heel pain. However, image findings can occur in asymptomatic individuals and may be absent in cases of plantar fasciopathy.
Evidence-Supported Heel Pain Treatment
* Manual therapy has been shown to be an effective intervention for plantar fasciopathy.
* A night splint in combination with foot orthosis has proven to be an effective intervention for plantar fasciopathy.
* Trigger point and dry needling have limited evidence for treating plantar fasciopathy.
* TENS shows no significant improvements in patient with plantar fasciopathy.
* Ultrasounds show no difference after the course of treatment in patients with plantar fasciopathy.
* Corticosteroid injections have limited evidence and the benefits do not offset risk.
* Plantar Fasciopathy surgery is considered if other less invasive treatments do not provide foot pain relief.
* Surgery may be necessary for heel spur/bone spur treatment in order to remove the excess bone growth. If you’re considering a surgical procedure to remove your heel spur, remember, bone spurs are also found in people without heel pain and some people with plantar fasciopathy do not show a bone spur. Heel spurs are a normal response to an abnormal stimulus. Identifying the abnormal stimulus from the faulty foot mechanics will result in restoring and distributing the proper loads through the foot, relieving your heel pain.
Summary
Due to several factors leading to heel pain, good history taking and diagnosis by the medical provider are required to identify the correct foot pain treatment. Evidence shows few interventions create long-lasting effects, but manual therapy has been shown to be an effective intervention. Faulty movement patterns lead to increased stress on the plantar fascia. At Apex Manual Therapy plantar fasciopathy (plantar fasciitis) patients are treated with manual therapy followed by movement training to assure manual therapy effects are maintained.
Are you suffering from shooting pain in the foot, pain in the arch of the foot, ankle pain, general foot pain or ball of foot pain? Schedule a free consultation with our advanced physical therapist to diagnosis the cause of your foot or ankle pain.
At Apex Manual Therapy, we’ll get you back on your feet.
