Plantar fasciitis is a common condition among adults and is often referred to as plantar heel pain, plantar fasciosis or plantar fasciopathy. Plantar fasciitis is an overuse injury that occurs due to increase in load or a decrease in capacity. An imbalance occurs in which the persons load outweighs their capacity, which leads to an irritation of fascia. There are many different sources of heel pain including; fat pad irritation, stress fractures, bursitis, nerve entrapment, lower back disorders and Rheumatiod arthritis, with all conditions being treated differently.
If you have been clinically diagnosed with plantar fasciitis the treatment may include both short term and long term interventions.
Short term interventions may include;
- Heel cups
- Heel raise
- Dry needling
Long term interventions are aimed at resolving imbalances that have caused the irritation and include calf, foot and hip strengthening, stretching and heavy loading of the plantar fascia specifically.
Osgood Schlatter's Disease
Osgood Schlatter’s Disease (OSD) is a common cause of knee pain in young, active adolescents. OSD is an overuse injury, characterised by inflammation of the tibial tuberosity growth plate where the patella tendon attaches. It occurs predominately in boys aged 12-14 and less commonly in girls aged 10-13. Other risk factors for developing OSD include high levels of activity during growth phases, sports that require large amounts of running, jumping and changing direction and tight quadricep muscles.
Symptoms of Osgood Schlatter’s Disease include pain, swelling and tenderness just below the knee, Adolescents generally report worsening of symptoms with jumping, stairs, running and kneeling on the affected area.
If you have been clinically diagnosed with OSD the treatment may include reduction of aggravating activities such as running and jumping. Taping and medication for short term relief. Quadricep stretching, strengthening of the muscles around the knee including hamstrings, quadriceps, calves and hip muscles and in some cases orthotics.
Patellar Tendon Pain
Many individuals experience front of the knee pain, this can usually be diagnosed as a fat pad irritation, patellofemoral pain syndrome or patellar tendon pain. The patellar tendon is a strong piece of tissue that attaches to the bottom of the kneecap (patella) to the top and front of the shin bone (tibia). Its job is to transmit forces generated by large quadricep muscles groups to the shin bone, which straightens your leg.
Patellar tendon pain usually builds up over time and is aggravated by repetitive jumping activities and typically eased by rest or ceasing the aggravating activity. Some people may also complain of a dull ache after a period of rest that goes away after they get up and moving.
A common reason for patella tendon pain is usually a sudden increase in training load, especially jumping activities. For example, increasing the number of training sessions per week, or introducing new exercises into a routine.
In terms of treatment short term strategies may include;
- Manual therapy
- Isometric exercises
- Load management to prevent further aggravation of the knee
In the longer term we usually look to strengthen the patellar tendon and the surrounding muscles through exercise.
Rotator Cuff Related Shoulder Pain
The rotator cuff is a group of muscles which originate on the shoulder blade and then attach to the head of the shoulder, surrounding the head of the humerus. Their role is to maintain the position of the head in the joint as you lift and move the arm through space.
Pain in the shoulder is common and is often attributed to the rotator cuff or surrounding structures. It can be from a tendinopathy, partial or full tear, can be acute or an overuse injury. People will often find pain when lifting the shoulder out to the side, above the head out in front or perhaps reaching behind the back into the back seat of the car for instance. Dysfunction of the rotator cuff can also lead to other conditions of the shoulder, like bursitis for example.
Having rotator cuff related shoulder pain can lead to discomfort with general day to day activities like hanging out the washing. It can also affect training, particularly with overhead movements or pushing movements like shoulder press, or bench press. You could feel as though your throwing distance has decreased or pain when throwing. If you’re having troubles with these movements, you could be experiencing rotator cuff related shoulder pain.
According to research, treatment of rotator cuff related shoulder pain, should involve exercise for long term effect. However short-term treatments can include, massage, dry needling, anti-inflammatories; including cortisone injection and short periods of rest. To determine the best course of action it is best to see your physio to establish a plan of action to improve your function with a goal in mind.