Nurses and plantar fasciitis: keep your hard-working feet healthy

As nurses, we spend plenty of time on our feet. This applies not only to nurses working on the bedside, but in addition to nurse educators, practicing nurses and many, if not all, other nursing professionals. With each step, our feet carry 3 times our body weight. When you concentrate on the grueling job responsibilities required in nursing, i.e. lifting patients, lifting equipment, and running code blue, to call a couple of, it puts a major amount of strain on our feet. Moreover, most of our walking and heavy lifting at work is completed on hard surfaces – the hospital floors, corridors and concrete stairs present in most healthcare facilities, which give a “sterile” environment but are unforgiving surfaces that do little to assist cushion our steps .

Plantar fasciitis is one of the crucial common causes of foot and heel pain within the United States. There are many risk aspects related to developing plantar fasciitis, including a body mass index of over 27, heel spurs, micro-trauma (from running, inappropriate footwear and prolonged running, walking or standing on hard surfaces), and underlying structural deformities reminiscent of flat feet. feet (pes planus), high arches (pes cavus), excessive pronation or limited dorsiflexion of the ankle. Despite many risk aspects, the condition is basically considered an overuse injury. Although the precise etiology is just not fully understood, it’s believed to be due partly to micro-trauma and inflammation resulting from prolonged standing, walking or running combined with the chance aspects mentioned above. Other aspects include ill-fitting or poorly supportive shoes and a recent increase in weight-bearing activity (i.e., a brand new running or exercise program).

Nurses are at high risk of developing plantar fasciitis on account of their job responsibilities. The plantar fascia consists of fibrous bands that attach to the heel (calcaneus) and connect with the toes (metatarsals). These bands provide support to the foot and in turn support the body’s weight during walking and any weight-bearing activities. The plantar fascia helps absorb shock through the windlass mechanism; when the toes straighten during weight bearing, tensile stress is applied to the plantar fascia and the peak of the medial longitudinal arch increases and maintains arch, stabilizes the foot and provides dynamic cushioning. There isn’t any elastic tissue within the plantar fascia, so all of the work is completed through this tensioning mechanism.

Common clinical symptoms of plantar fasciitis include pain within the plantar aspect of the heel, pain that’s worse with step one within the morning or after an extended period of inactivity, and similar heel pain after long periods of weight-bearing (e.g., a 12-hour shift). Onset is often on account of a recent increase in load (latest exercise program, etc.). Clinical examination reveals tenderness along the plantar fascia, particularly on the calcaneal insertion. The “windlass test” also often gives a positive result (heel pain reproduced with passive dorsiflexion of the toes). If you experience foot or heel pain, proper diagnosis is essential.

Once plantar fasciitis is diagnosed, the mainstay of treatment is often conservative measures including a mixture of stretching (each calf and plantar fasciitis), ice packs, rest, orthotics, strength exercises to stabilize the foot and ankle, and short-term nonsteroidal pain medications. -anti-inflammatory drugs (NSAIDs). Physiotherapy can be a really useful treatment method. Let’s take a look at a few of these treatments.

Treatment

House

• Rest (and avoiding aggravating activity)
• ice
  • Try freezing a plastic water bottle (~16 ounces); once frozen, roll under your foot to freeze your complete plantar fascia.
• Short-term over-the-counter NSAIDs (for acute pain)
• Stretching
  • Try rolling a tennis ball under your foot, massaging the plantar fascia.
  • Perform stretching exercises that deal with the calf (gastrocnemius and soleus), hamstrings, and Achilles tendons.
• Over-the-counter orthotics (targeting rear foot pressure distribution)
  • Heel support (heel cushioning to assist absorb shocks); silicone heel cups
  • Medial arch support inserts
• Properly fitting shoes (Read)
  • Motion control shoes
  • If you’re employed several days in a row, consider changing your shoes.
• Limit the time you walk barefoot or in flip-flops.
• Consider foot reflexology or a massage from someone experienced in treating plantar fasciitis.

Physical therapy

Usually includes:

• Proper assessment of foot posture and underlying structural deformities
• Manual therapy (massage, myofascial release) aimed toward mobilizing the plantar fascia, gastrocnemius and soleus muscles, joint mobilization
• Stretching (calves, hamstrings, rear muscle groups)
• Anti-pronation taping
• Foot orthoses
• Night splints (maintains static stretch when you sleep)

Orthopedist or podiatrist

Potential treatments:

• Corticosteroid injection
• Cast or controlled ankle movement (CAM) walker (shoe); each designed to forestall heel stress and promote rest
• Extracorporeal shock wave therapy (ESWT); improves neovascularization of the painful area by causing micro-injuries that stimulate the healing process
• Surgery; loosening of the plantar fascia within the heel bone (performed endoscopically)

Remember that as nurses we’re lucky to work able that keeps us on our feet! From a health perspective, we don’t face many health problems related to long periods of sitting and dealing at a desk. There are industries dedicated to combating sedentary work by creating an ‘lively office’ – these interventions include standing desks, treadmill desks and under-desk bikes, all specializing in ensuring movement at work. This is already built into our work. I once talked to a cardiologist in regards to the importance of sitting while standing, and she or he stated that “sitting is the new smoking,” emphasizing the importance of exercise and avoiding prolonged sitting on account of its antagonistic health consequences. As nurses, lots of us have jobs that get pleasure from being on our feet. That said, to make sure optimal performance and luxury at work, we want to handle our foot health and well-being. The best ways to forestall plantar fasciitis are to wear appropriate footwear at work, maintain a healthy weight, routinely stretch after an extended shift, and when starting a brand new exercise or running program, work towards your goal moderately than specializing in your first workout. Finally, concentrate to your feet, for those who feel pain, ask for an assessment. In our busy skilled and residential lives, let’s not forget to pay some attention to our feet.

Do you will have any tricks or suggestions that you just personally use to maintain your feet healthy? Please Share!

Koc, T. A., Jr, Bise, C. G., Neville, C., Carreira, D., Martin, R. L., & McDonough, C. M. (2023). Heel Pain – Plantar Fasciitis: 2023 version., (12), CPG1 – CPG39. https://doi.org/10.2519/jospt.2023.0303

Schneider, H. P., Baca, J. M., Carpenter, B. B., Dayton, P. D., Fleischer, A. E., & Sachs, B. D. (2018). American College of Foot and Ankle Surgeons Clinical Statement: Diagnosis and Treatment of Acquired Heel Pain in Adults. , (2), 370–381. https://doi.org/10.1053/j.jfas.2017.10.018