Every now and again as a
Gordon, an active gentleman in his 50’s, attended our clinic back in July 2016 complaining of longstanding pain at the base of his right heel.
Following advice from a family
Gordon attended the clinic for a consultation with our lead podiatrist; Scott Shand and we began the session by obtaining a detailed account of the patient’s medical history, the nature of the condition and site of the pain.
It was ascertained that this problem had been with him for over 20 years. In his line of work as a
He tried stretching, ice packs, pain relief medication and altered the type of shoe he wore daily, this strategy did little to ease his symptoms
On examining the sole of his right foot,
Gordon reported no history of direct trauma (no falls, knocks, broken bones or accidents) and his medical history was generally very good for a gentleman of his age. He did not complain of any other joint pains or illness and his weight was normal.
Given the site of palpation pain and the pattern of
Our treatment protocol and objectives were:
- Improve the range of motion at the restricted joints of the foot
- Improve the tissue viability (condition the soft tissues of the foot using massage techniques)
- Create a localised inflammatory response (stimulate the area of pain/site of injury to increase blood flow to the area)
- Reduce the forces on the affected area and reduce the tension on the muscles and ligaments of the arch
- Stretch and strengthen the foot and leg muscles
For chronic heel pain conditions we classically use shockwave therapy but as Gordon was taking low dose aspirin we could not use this treatment at this time. He agreed to abstain from use and we would use the treatment in due course.
Our first treatment session involved mobilisation of the ankle joint and the joints that comprise the arch of the foot as these joint were found to be very tight and restricted in motion. This was achieved by the application of a series of low force mobilisation techniques.
We coupled this with dry needling of the heel bone,
Gordon’s initial feeling was that when standing and walking, the foot could now move and bend easier and felt less tight. We booked another session for 1 week later and instructed calf and arch stretching exercises to be completed daily.
For this reason, we continued with the treatment protocol of mobilisation of the joints, acupuncture and deep tissue massage. Again, immediately, he felt the foot freer and an ability of the foot to bend and rotate more naturally.
On our third visit, Gordon commented that this was the best his foot had felt in 20 years and the pain was now at a much more tolerable level. At this
The custom foot orthotics were designed to reduce the forces acting upon the heel bone and to reduce the arch from dropping. The dropping of the arch increases the tension on the soft tissue in your arch, namely the Plantar Fascia. As these soft tissues insert into your heel bone, increased tension will likely lead to trauma at the insertion point and subsequent pain.
This process involved laser scanning the feet to capture an accurate 3D scan of the feet, designing the orthotics using computer software and the processing of a file which we sent to our dedicated fabrication facility, Epione Orthotics, in Aberdeen.
The resultant orthotic devices were made of a soft, rubberized foam material.
Shockwave therapy has been well documented in the medical literature for the treatment of chronic heel pain and Achilles conditions. We believe that the treatment increases blood flow to the injured tissue and re-engages the body’s natural healing mechanism. Great results have been seen at the clinic for stubborn heel pain cases. Three sessions of shockwave therapy were booked, one week after another. The sessions lasted 10-15 minutes and produced only minimal discomfort.
We were amazed at how quickly a chronic painful condition could be helped so significantly enabling our patient to get back to enjoying his game again and enjoying an active, happy retirement.
After 20 years of heel pain, Gordon believed that nothing would help him. Podiatric intervention proved very helpful and he was happy with the improvements made.