Advice please - Plantar fasciitis in south London

[krislondon]

Advice please - Plantar fasciitis in south London

Hi all. I was hoping to get some advice from you. Ive had plantar fasciitis for around 6 months now in both feet, although the left is worse. Although it is more of a niggling pain now, and im quite comfortable walking moderate distances im not yet running again, the plantar fascia of my left foot in particular is still quite tender around the area where the arch should be (I don’t have much of one as im flat footed).

It was caused by running and being flat footed (I think).

I have the custom orthotics and im doing the massage, ice bath stretching and strengthening excercises most days but I need to get rid of it asap as im due to start a new job that involves lots of running and time on feet quite soon.

I went to a general physiotherpaist for around 2 months which seemed to help somewhat, but then I went away for a few months.

Now im on my way back to London I was wondering if anyone knows of a (lower limb/plantar fasciitis) specialist preferably south, or failing that central London. Is it worth trying to find someone who specialises? My last physio sessions involved massage and ultrasound is there any other treatments that a physio can offer?

Also what do you think about the hydro cortisone shots or Extracorporeal shock wave therapy?

Any advice greatly appreciated. Apologies if i got the lingo wrong

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[krislondon]

ok sorry that was possiby too long winded

All i really need to know is how to choose the best physio in my area for my problem. Sure i can phone them up but what do i ask them?

cheers

[karen.hankey]

The way to find a good physio is to ask when you phone up if there is someone who specialises.

Have you considered a podiatrist, due to the flat-footed aspect, you may need orthotics. Just a thought

[oscar]

Have you tried: PhysioFirst Physiotherapist Directory

and look under sports injuries for someone local?? Might be worth ringing them and asking if they specialise in that area. I agree a podiatrist is probably the way forward, if yours is a biomechanical problem then custom made orthotics are probably your best bet....pricey but may be worth it. See if you can get referred to a specialist podiatrist, there is obviously an underlying mechanical cause as to why you are suffering with this.

Other thing you could try is myofascial release- it's meant to be very good for plantar fasciitis. Plenty of these guys around too....

[alophysio]

Hi - if you call a physio and ask if they do plantar fasciitis, most would say yes so don't waste your time (i know i would say yes!).

Perhaps better to get referred to someone a foot specialist has been involved with if you really want someone with the runs on the board... but even that has flaws.

You can do the massage and U/S but i am a fan of taping, frozen bottle icing (roll your foot on it), dowel stick releases, "toe crawls" - where you are standing and curl only your toes to drag yourself inch by inch over 10 feet! I also check the "lower limb kinetic chain" (a fancy way of saying ankles, knees and hips) as well the pelvis and L/S.

If it is running that has caused it, seek a running coach who is a trained physio, biomechanist or sports scientist. I use one here in Sydney with my runners and they love him! Solves so many repetitive injury problems with their technique (i don't pretend to be an expert in running technique, just with what i know...)

Good luck!

[nmarman]

Hi,
Late coming, I know, but often traditional techniques only alleviate the pain or control it - so maybe you are still suffering.
The answers you had so far are all correct and I would reinforce the need to stretch the plantar fascia on a regular basis.
A tight calf, although wont directly cause pain, will change the bio mechanics of your running style. Meaning you are inclined to run and load the forefoot. This in turn makes the toes lift repeatedly. The toe lift movement tightens the plantar fascia eventually leading plantar fasciitis.

The problem comes when the condition is chronic because the tissue has now hardened way beyond where stretching and massage (even ultrasound - although I have had a case or two which this worked well for) can help.

The answer at this stage is ESWT or Shock Wave Therapy it has been proven to help a massive majority (>80%) of chronic suffers (>3months of pain).

There is the London Shock Wave Therapy & Sports Injury Clinic in South West London if that helps or the London Foot pain Clinic also in South west London.

Here is a link to the London Foot Pain Clinic which specialises in Plantar Fasciitis treatment and also offers Shock Wave Therapy (ESWT). There web site has exercises and a detailed home treatment plan of anybody that has only had pain for a few days/weeks. Also it is filled with information on PF:

London Foot Pain Clinic

[alophysio]

Thanks for that nmarman

Do you have a reference for your stats apart from the website - as in journal research articles?

Thanks

---------- Post added at 09:27 AM ---------- Previous post was at 09:23 AM ----------

I just did a quick search of PEDro and found the 2002 meta analysis...

Other research articles are here...

PEDro - Search Resultshanks again!