I am Dr. Premkumar, diabetic foot surgeon.So, first of all, I want to thank you all for supporting me on my YouTube channel, and this is my attend to the video going to upload. So once again, I just want to convey my thanks to you all.
So this video is all about plant art facilities or healing pain. Commonly know young female as well has no middle aged female come with heel pain, particularly those who are overweight and those who are having Fasciitis and those who are office goes usually wear high heel footwear. So when we come to the topic of plantar fascinating or heel pain first, important thing we need to know is about the plantar fascia. So this is the plantar fascia which runs from the ball of the foot and attaches it to the calculium here.
So it has lateral band, medial band and central band. So what we call central bank is plantar aponeurosis. So usually, females or office workers tend to tell they have this kind of heel pain, especially in the morning when they start walking the first step. So what is the mechanism throughout the day? And I know the plantar fascia is relaxed.
When they suddenly keep the foot down in the early morning, they usually feel a short pain here they will have for more than some patients may have more than a year also. So the predisposing factor for all this plantar fugitive or heal pane or galcons. All these things are over by one thing or flat foot or a tight Pento Achilles, or there is a projection of the bone in the attachment of plantar fascia that is calculus per. So these are the main predisposing factors. Sometimes 30% of the individual will have this kind of heel pain on both feet also.
So the investigation for this is local ultrasomograph. So we need to measure the thickness of plantar fascia and then hypoecogenic area any degeneration. So all these things we need to be looked in auto pornography. So the management of this planter appreciated is conservative most of the time. So it requires exercise.So plantar facial stretching excess Tendo acidis stretching excess. So along with custom insoles which supports the arch of foot and then two exercise which I am going to demonstrate today. This is usually for mild to moderate case of Blanchard fascia. This is enough. If the blanket fascia is pain is not subsiding with this one.We can able to give a local PRP injection or some doctors prefer to give a steroid injection along the insertion of the plantar fascia. And along with this stretching express so very thoroughly we do plantar fascia release surgery for chronic plantar facilities, which is not subsiding by this kind of conservative management. Now I’m going to show you that exercise regimen for plantar efficiency. So when we come for plantar facilities stretching exercise, the patient should be taught to do a great toe stretching extension with the dorsiflexion so.
This needs to be repeated ten times, and this toe has to behold in position for 10 seconds, and then you need to relax, then 10 seconds with the dorsiflexion and then relax.
So what is the purpose of doing this one? A bendless mechanism stretches the plantar facial. So whenever you do dorsiflexion, stretch this one so the blank of the sheet is stretched. So ten times, you need to repeat this before stamping your foot down in the early morning after rising out of bed. So the second exercise, you can also use simple towels.
The knee should be kept straight without flexing, and then this has to be pulled like this, and this has to be holding the position for 10 seconds. You see, this plantar fascia is getting stretched and then relax.
This needs to be repeated again for five minutes. The other way is I see water bottle rolling. They can fill this water bottle and keep in the refrigerator. Once it forms ice. The patient can keep under the feet and they can start rolling so this will reduce the pain, and this needs to be repeated till they feel comfortable.
If the other form of this one is using a chapati roller, they can use a similar kind of rolling with this kind of chapati roller. So the commercially available product for this kind of healing is plant based on the night split. It holds the plantar facial stretch throughout the night. That also patient can try so to be insured. Management of land efficiency is stretching X rays and then night splint, sometimes a PRP or a sterilized injection locally and a custom made insert.
So all these things on the physical therapy part, sometimes they will give extra garporial shock wave therapy and the autocomplete therapy. Both are equally good, but the thing is, in extra corporal shockwave therapy, the patients feel comfortable very fast compared to your ultrasound therapy, and the extra heart therapy is once a week regimen for three weeks. And for this ultrasound, regular autosome therapy is twice a week, so for three weeks. But the benefit of good therapy is somewhere lower than an extra carpool shop with therapy; we usually suggest extra carpool shop with therapy be for patients with brand appreciated.
Thanks for watching.