Plantar Fasciitis and Heel Pain Treatment in Cheadle Hulme

The plantar fascia is the thick band of tissue running along the sole of your foot, connecting your heel bone to your toes. When it is strained or overloaded, it can cause pain on the bottom of your foot, around your heel and arch.

It is more likely to be plantar fasciitis if:

• the pain is much worse when you first start walking after sleeping or resting
• it eases a little once you get moving, but gets worse if you stand, walk or run for a long time
• it is painful to stretch the sole of your foot, for example when you raise your toes or walk upstairs

It is not always clear why plantar fasciitis starts, but you may be more likely to get it if you:

• are between 40 and 60
• do a lot of standing, walking or running, or have recently done much more than usual
• have started exercising on hard surfaces
• have tight calves, flat feet or high arches
• wear shoes with poor cushioning or support
• are overweight

Heel pain is not always just a foot problem. As an osteopath, Wes looks at the whole picture: your calf flexibility, ankle mobility and foot mechanics, and how your knees, hips and lower back are moving. Tightness or stiffness further up the chain can add load to the plantar fascia, so addressing it is part of the plan.

Your first appointment lasts 45 minutes and includes a full case history and examination. Wes will explain what he finds and talk you through your options, including whether shockwave therapy is suitable for you.

Extracorporeal shockwave therapy (ESWT) is a non-invasive treatment. A handheld device delivers acoustic pulses into the painful tissue, with the aim of stimulating the body's own healing response. The NHS lists it as one of the options when plantar fasciitis has not improved with simpler measures.

It is important to be clear about the evidence. NICE guidance on shockwave therapy for plantar fasciitis that has not responded to other treatment (IPG311, now HTG200) found no major safety concerns, but describes the evidence on how well it works as inconsistent. NICE advises that it is used with clear patient information, consent and audit of outcomes. Wes will talk this through with you honestly, so you can decide whether it is right for you.

What a session involves: a shockwave appointment lasts 30 minutes, of which the shockwave itself takes about 5 to 10 minutes. Wes applies gel to your heel and uses the shockwave device to deliver between 2,000 and 3,000 pulses. You may feel some discomfort, but the intensity is adjusted to your comfort throughout. Afterwards, some people notice redness, slight swelling or tenderness for 24 to 48 hours. Bruising is occasionally seen.

Shockwave is not suitable for everyone, so Wes will go through your medical history before treatment.

Most people have between three and six shockwave sessions, spaced a week apart. Wes reviews your progress at every visit and adjusts the plan. Everyone responds differently, and improvement can take time, so he will give you an honest view of what to expect.

Shockwave is never used on its own. Your plan may include:

• hands-on osteopathic treatment to release tight calves and improve joint mobility
• a tailored home programme of stretching and strengthening exercises for your foot, calf and lower leg
• advice on footwear, activity levels and building back up to walking, running or golf

A podiatrist (foot specialist) can recommend insoles, orthotics, footwear and night splints, and is the right professional for foot problems linked to diabetes, nail or skin conditions. If Wes thinks you would benefit from podiatry, alongside or instead of treatment with him, he will tell you.

In line with NHS advice, these steps can help:

• rest and raise your foot when you can
• hold an ice pack wrapped in a towel on the painful area for up to 20 minutes, every 2 to 3 hours
• wear shoes with cushioned heels and good arch support, and try insoles or heel pads
• do regular gentle stretches for the sole of your foot and your calf
• choose activities that do not load your feet, such as swimming
• avoid walking barefoot on hard surfaces, flip-flops, backless slippers and high heels
• ask a pharmacist about suitable pain relief

Not sure which appointment to book? Call 07852 130 685 and Wes will advise. Find out more about shockwave therapy.

• Registered osteopath. Wes Tubb holds a Master's degree in Osteopathy (M.Ost) from the British School of Osteopathy, with post-graduate training in classical osteopathy and clinical acupuncture. You will see Wes at every appointment.
• Whole-body assessment. Your hips, knees, ankles and feet are assessed together, not just your heel.
• Evening and Saturday appointments. Monday to Thursday, 10:30am–8pm, and Saturday, 8am–12pm.
• Sport and golf know-how. Wes is a Titleist Performance Institute (TPI) certified Golf Medical Professional. Heel pain from walking the course is something he understands. See the Golf Injury Clinic.
• A private clinic in Cheadle Hulme at 10 Oak Avenue, a few minutes from Cheadle Hulme station, with free street parking outside.

We see patients with heel pain and plantar fasciitis from across the local area, including Cheadle Hulme, Bramhall, Cheadle, Heald Green, Gatley, Hazel Grove and Stockport.