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Plantar Fasciitis – The Ins And Outs Of This Frustrating Condition!

Here at my clinic, I see plenty of patients suffering from heel pain. They almost always have a similar story:

“I have an extremely painful sensation right on the heel of my foot”
“My pain is always there in the mornings, and after I do any activity!”
“I’ve had to stop my running because I just can’t bear the pain”
“The pain seems to ease as I move but it kills me immediately after”
“If I sit at my desk for an hour or so, then get up to move I can’t walk with the pain in my heel!”

All of these complaints are those you would expect from somebody suffering from Plantar Fasciitis. You may have heard of this frustrating condition before – especially if you are a runner or work on your feet a lot!

In this week’s column, I hope to give you the correct and most up-to-date information on this condition and how to treat it.

What Is The Plantar Fascia?

The plantar fascia is a flat band of tissue that connects your heel bone to your toes and supports the arch of your foot.

What Is Plantar Fasciosis? Is It the Same As Plantar Fasciitis?

Plantar Fasciosis is an overload injury of the plantar fascia. It is degeneration of your plantar fascia. This condition has historically been called plantar fasciitis because it was believed that plantar fascia inflammation was the principal underlying cause. Plantar fasciosis is a more accurate name for this condition because it involves degeneration of your plantar fascia, not inflammation.

Why Me? What Can Cause Plantar Fasciosis?

It is very common in runners due to the repeated stress being placed on the fascia – can sometimes be linked to poor running technique but more often than not the process of doing too much too soon is enough to overload the fascia.

Plantar Fasciosis is very common among beginner runners who might go from doing no running at all straight into a 5km run. This is too drastic of a change for the body to handle in such a small space of time and the plantar fascia isn’t used to this amount of stress and becomes
irritated and painful.

Another common group of people who suffer from Plantar Fasciosis are those who work on their feet all day. 50% of Plantar Fasciosis sufferers are on their feet all day.

Our Top 6 Tips For Providing Some Relief!


Stretching of the plantar fascia and/or calf muscles can provide some people with relief! Try to gently stretch your calf and plantar fascia twice a day and you might see some

Gel Inserts/Heel Pads

these heel pads can be bought at a relatively no cost compared to more expensive custom orthotics and have been shown to be just as effective – give it a go and see if you feel the benefits!

Ice Or Heat

Applying Ice or heat to the Plantar Fascia has been effective in reducing symptoms short-term in a handful of patients but is not guaranteed to work in everyone. You could start by rolling your foot on a frozen water bottle for 10 minutes every few hours and see if it helps you! Remember to put a towel between your skin and the bottle to avoid ice burns!

Night Socks

There are a range of night socks available – some more comfortable than others, it’s important to find the one that you find most comfortable! Night socks don’t work with
everyone, however, they are only effective in about 1/3rd of people.

Reducing The Load On Your Foot

This is the most important tip we can give you. The act of adjusting your activity levels and reducing the stress on your plantar fascia can bring some decrease in symptoms – the important part then is how we load it back up.

Load It Back Up

Once the pain has settled a gradual loading programme has been shown to be the best way to gain long-lasting relief from this frustrating condition.

Struggling With Plantar Fasciitis?

If you’ve recently been diagnosed with plantar fasciitis or you suspect it could be why your foot is painful and swollen, we can help you get back to doing your favourite activities foot pain-free!

Right now, we’re offering you the chance to book a free telephone consultation where you can speak to one of our expert physiotherapists about your foot pain problems, ask your important questions and get clarity from the answers about how physiotherapy can help you!

If you’ve had enough of foot pain ruining your favourite sports and activities arrange a free telephone consultation by calling our Lucan clinic at 086 787 6358.

Other Free Resources For Plantar Fasciitis 

Read Our Blog – Shockwave Therapy For Plantar Fasciitis

Read Our Blog – Patellofemoral Pain Syndrome

On Social Media? Follow Us On – Facebook, Instagram, YouTube 

Six Key Tips for Smashing Rehab of Patellar Tendinopathy 

Recently experienced a patellar tendinopathy injury and you’re unsure about your next steps?

It’s understandable you may be confused as often patellar injuries aren’t explained very well, it can be a long recovery process and an unclear path dependent on your progress.

Patellar tendinopathy affects the knee and in turn, can affect the way you walk, the way you run or the way you play your favourite sports potentially meaning you miss out on valuable training time.

So we’ve written this blog to help you to stay in the game and give you some clarity on what a patellar injury really means and the six key steps to manage the recovery process that comes with it.

What Is Patellar Tendinopathy?

Patellar tendinopathy, commonly known as jumper’s knee, is a prevalent overuse injury characterized by pain and dysfunction in the patellar tendon.

This condition predominantly affects athletes involved in activities that require repetitive jumping and landing motions such as athletics-style sports including hurdles, long jump and high jump.

Patellar tendinopathy is a frustrating and debilitating injury, plus, its management is poorly understood, which can lead to mismanagement. But to help you manage your recovery better we’ve included six key factors to managing patellar tendinopathy and maximising results during the rehab process.

Step 1: Get An Accurate Diagnosis

The first step in managing patellar tendinopathy is obtaining an accurate diagnosis. This typically involves a thorough clinical examination, including detailed patient history and physical assessment.

The presence of localized pain, tenderness over the patellar tendon, and pain during activities such as jumping and squatting are key indicators of tendinopathy.

X-rays and MRIs are not required for the diagnosis, and can often delay the rehabilitative process.

Step 2: Understand Tendinopathy Injuries

Any tendinopathy injury can be frustrating for both athletes and individuals leading an active lifestyle.

One of the reasons for this frustration is the prolonged healing process associated with tendinopathies, which can often take longer than other soft tissue injuries.

Unlike muscle strains or ligament sprains that generally heal within a few weeks, tendons have a relatively poor blood supply, making them more susceptible to slow healing and tissue degeneration.

The slow pace of recovery can test one’s patience and resilience, requiring individuals to adopt a long-term perspective and commit to a comprehensive rehabilitation program.

Understanding the nature of tendinopathies and their extended healing timelines is crucial in managing expectations and remaining motivated throughout the recovery journey.

Step 3: Load Management

Load management has emerged as a key principle in the management of patellar tendinopathy. Instead of complete rest, it is now recognized that appropriately dosed loading is necessary for tendon adaptation and recovery.

The load applied to the tendon should be carefully managed to avoid excessive stress while still promoting tissue healing and remodelling.

This involves adjusting training volume, intensity, and frequency to find the optimal balance between tendon recovery and progression.

Step 4: Managing Your Pain

During tendon rehabilitation, it’s important to expect some discomfort. Mild to moderate pain during exercises is considered normal and even beneficial as it indicates appropriate loading for tissue remodelling.

However, it’s essential to differentiate between acceptable pain and excessive or lingering pain. Watching how the knee responds 24 hours after activity can be helpful in guiding progressions during the rehabilitation process.

Step 5: Strength Training

Gradual strengthening of the glutes and quadriceps forms an integral part of the rehabilitation process.

Both isometric and eccentric exercises have shown promising results in the management of patellar tendinopathy.

These exercises promote tendon remodelling and increased load tolerance. Below are some examples of exercises from our YouTube channel that can be incorporated throughout the rehab process.

Stage 1 Recovery Exercises

Stage 2 Recovery Exercises

Stage 3 Recovery Exercises

Step 6: Gradual Return to Sport

Returning to sports or activities should be a gradual process. Following a period of activity modification and strengthening, the individuals can make a gradual return to activities that were previously troublesome, such as running, jumping and cutting.

Poor management of patellar tendinopathy- such as an early return to sport- can lead to an increased risk of re-injury and sub-optimal athletic performance.

Struggling With A Knee Injury? Shockwave Therapy Could Help!

If you’ve recently had a knee injury and you’re in the midst of a recovery you think is never gonna end, shockwave therapy could help you accelerate the process AND get you Dublin Marathon ready!

Here at Pain and Performance Clinic, we’re passionate about getting you back to doing the activities you love without injuries getting in the way and stopping you from making the progress you strive for.

Right now, we’re offering you the chance to book a free shockwave telephone consultation where you can speak to one of our expert physiotherapists about your pain problems, ask your important questions and get clarity from the answers about how shockwave therapy can help you!

If you’ve had enough of knee pain ruining your favourite sports and activities arrange a free shockwave therapy telephone consultation by calling our Lucan clinic at 086 787 6358.

Other Free Resources For Shockwave Therapy & Injuries 

Read Our Blog – Shockwave Therapy For Plantar Fasciitis

Read Our Blog – Patellofemoral Pain Syndrome

On Social Media? Follow Us On – Facebook, Instagram, YouTube 

What is required for a comprehensive late stage ACL rehab programme?

A late stage ACL programme should be progressive, tailored to individual needs and should be split into resistance-based and field-based programmes. The athlete undergoing the programme should be supervised by a qualified physiotherapist.

The resistance based programme should focus on double and single leg strength progressing on from early stage rehab. The physiotherapist should choose 5-6 exercises to be performed 2-3 times per week. The exercises that are chosen should include two compound movements such as a squat or deadlift and the programme should allow for variety in the movements (front squat, split squat, single leg RDL etc.). The chosen exercises can progressed by increasing exercise load or depth of the movement. The resistance programme should also include single leg power exercises such as vertical jumps, bounds, lateral jumps and combined movements.

It is vital for the programme to address single muscle groups including the quadriceps, hamstrings and calf muscles. The importance of isolated quadriceps and hamstring movements is to prevent muscle strength deficits that may be masked in a squat or deadlift by high levels of hip strength. Finally, bonus exercises including core strengthening, hip and groin strengthening and higher level hops may also be incorporated.

The field-based programme should include a comprehensive warm up and light running drills, high speed running and sprinting which can be progressed to acceleration and deceleration movements, multidirectional movements and finally to sports-specific skills and drills.

Running drills and the warm up may mimic injury prevention programmes like the FIFA 11+ or GAA 15 programmes. This allows the athlete to return to light field-based training without compromising the ACL.

This programme can then be progressed to high speed running and sprinting. The distance and speed should be progressed over a number of weeks and should finish with the athlete reaching 100% of their pre-injury level pace. An example of an initial programme may look like:

  • Week 1-2 – 60mx5
  • Week 3 60mx5, x2 sets
  • Week 5-7 60mx5, x3 sets
  • Build 80%, 85%, 90%, 95%, 100%

Acceleration and deceleration may be introduced lightly by incorporating a walk-jog-run-jog-walk type drill.

  • Walk 10-15m, jog 25m, run 60m at 80-100%, jog 25m, walk 10-15m of a 130-145m GAA pitch

This drill can be progressed by shortening the distance to reach top speed and then to include short acceleration and deceleration bursts between cones. When an athlete is comfortable with double leg acceleration to deceleration, this should be progressed to single leg. Multidirectional and change of direction movements should be included following successful implementation of straight-line activities.

Finally, sports-specific skills and drills should be implemented including kicking, tackling, falling and rolling. The athlete should then be subjected to inanimate stress 1vs0 (cone) or coach stress (respond to certain skill). They should then be exposed  to player stress such as small sided games 1vs1 and progressed to small sides games 3vs3. The direction, speed, distance, combined drills and predictability of the drills should be manipulated to challenge the player. The athlete should be progressed through sport-specific drills/skills phases based on competence, confidence and volume.



A Simple Guide To ACL Rehabilitation

ACL injuries are often feared by many athletes given the long-term rehabilitation that is required to recover fully.

However, the principal message is always that ACL rehabilitation is a step-by-step process that gives the athlete an opportunity to condition themselves back to a pre-injury level of performance or even better!

A comprehensive ACL rehabilitation programme should be designed to address strength, stability, mobility and functional movement.

It should also consist of different phases that focus on criteria-based progression as opposed to time-based progression.

This post will take you through an ideal rehab programme for athletes who have been injured during their sport as well as some example exercises that can be used along with the stages of your programme.

Basketball Player With ACL Injury

The Prehabilitation Phase

Ideally, rehab should begin prior to surgery and is also known as prehabilitation. This phase allows the initial swelling from the knee to go down and settle and for the injured patient to regain as much strength and function as possible prior to surgery.

This can be achieved through regular icing of the knee, and low-impact exercises such as cycling and strengthening exercises.

It’s important to note that during this phase it’s important to avoid aggressive direction changes and high-impact activities such as running and jumping as this could aggravate the injury.

Athletes should also be provided with education regarding the surgery, expected recovery times, and the importance of compliance with the ACL rehabilitation program.

Following surgery, the emphasis of early rehabilitation is focused on restoring the normal range of motion in the knee, particularly a full extension of the knee. Emphasis should also be put on reducing pain and swelling while minimising any muscle wasting that could have happened post-surgery.

Phase Two

Once the range of motion in the knee has been restored phase two can commence.

This typically involves progressive strength training initially implementing light load or body weight exercises which can be progressed as tolerated. Cycling and easy plyometric exercises can often be re-introduced around the 4-6 week mark.

The main goals of this phase are to regain the majority of leg muscle strength, balance and function. An ACL rehabilitation programme during this phase should be performed three to four times per week.

Here are some examples of exercises to do in this phase:

Phase Three

Phase three of an ACL rehabilitation programme should focus on increasing strength and volume by progressing exercises’ intensity, resistance and complexity to challenge the muscles and enhance functional movements.

This phase usually allows for the reintroduction of field-based straight-line running into the programme. However, athletes must meet certain single-leg and plyometric criteria prior to this.

Change of direction, agility and plyometric exercises may be further progressed as the athlete tolerates following a successful introduction of straight-line running.

Here are some examples of mid-stage ACL exercises to try:

Phase Four

The fourth phase of an ACL rehabilitation programme shifts to a power focus to include exercises such as box jumps, plyometric lunge jumps, countermovement jumps and bounds. Strength and field-based training should be continued throughout this phase and the exercises should be sports-specific to prepare the athlete for their return to play.

Athletes generally return to sport around 6-9 months into their recovery, however, timelines may vary between individuals. Prior to returning to play, athletes must pass a number of hopping, strength and agility tests to ensure they’re ready to return to full play. The athlete’s psychological readiness to return to play should also be considered an important factor to return to play.

Preventing Re-Injury

The final step in an ACL rehabilitation programme should be to prevent another ACL injury. It’s important for an athlete to incorporate injury-prevention exercises into their normal routine. The injury prevention exercises should consist of double and single leg strength and plyometric movements.

Are You Having Trouble With An ACL Injury?

Have you recently experienced an ACL injury during sport and you’re unsure how you can progress? Or are you in recovery and are having no success improving your performance and getting back to your best to get back into your sport?

Here at Pain and Performance Clinic, we’re passionate about getting you back to doing the activities you love without injuries getting in the way and stopping you from making the progress you strive for.

Right now, we’re offering you the chance to book a free knee pain telephone consultation where you can speak to one of our expert physiotherapists about your pain problems, ask your important questions and get clarity from the answers!

If you’ve had enough of knee pain ruining your favourite sports and activities arrange a free knee pain telephone consultation by calling our Lucan clinic at 086 787 6358.

Other Free Resources For Knee Pain

Read Our Blog – You’ve Injured Your ACL – Now What?

Read Our Blog – Patellofemoral Pain Syndrome

On Social Media? Follow Us On – Facebook, Instagram, YouTube 

MRI Scans For Back Pain: What Does It Mean?

So picture this, you’ve just had MRI scans for back pain and you’re eagerly waiting for the results, but you’re not sure what an MRI scan really looks for, or what all of the (often scary sounding!) medical terminology means.

It can put you even more on edge when all you really want is for the back pain to go away, get back to your regular routine, and live life to the fullest again!

So I’m here to tell you everything you need to know about MRI scans for back pain, what they tell us about our spines, and simplify all of the medical jargon you could come across.

Where Did MRI Scans For Back Pain Come From And What Do They Mean?

If you can believe it, in the 1800’s back pain was associated with evil spirits this was based on expert opinion and society’s thinking at the time!

Of course, today if you have back pain we know there’s a scientific reason behind it such as lifting heavy objects, overuse injuries, or osteoarthritis. We try to find the cause of it on MRI machines.

Healthcare providers started to look at the human body through X-rays in the 1800s and were able to see the spine leading to cutting-edge treatments for sciatica in the 1930s which involved surgery to remove pressure on the discs in the back.

Over 90 years later, this is still the focus! Despite advancing technology and high-tech scanners, back pain is increasing in the population leading to people not being able to do simple tasks like tie their shoes or pick up their shopping.

And I know that the biggest predictor of back surgery is actually a previous back surgery!

If someone has had back surgery in the past it’s very likely they will need another because of a failed attempt or it’s worked for a while but has provided no permanent solution…

But There Is A Better Way!

MRI scans for back pain tell us a lot about what our spine looks like inside our bodies, but they don’t tell us anything about the pain the patient is going through, after all, you can’t find pain in a picture.

So just because your healthcare professional saw something on your MRI scan, does it mean you’ve found the cause of your pain, you have to cease all activity or stop doing the things you love?

Or can you improve without doing those things regardless if your MRI scan shows something’s wrong? I’m here to tell you that yes, you can!

Let’s Talk About Results

Firstly, let’s not forget that MRI scans for back pain have to be interpreted by humans. Unfortunately, you can show the same MRI scan to ten specialists and you can get 10 different results!

More often than not MRI results aren’t really explained well to people. The terminology used sounds very threatening, things like degenerative disc disease, bulging discs, stenosis, and slipped vertebrae are often reported.

That sounds scary and would understandably make you concerned and fearful for your back health. However, these findings are often normal age-related changes found in people who have absolutely no back pain too, so it may not be as serious as you once thought.

Coming from expert physiotherapists like us that have combined years of experience, the key message here is just because your MRI scan reports findings that does not mean you have to hurt and stop living the life you want.

But What About Things Like Bulging Or Herniated Discs, Isn’t That Serious?

Again, these words are scary to a patient like you who has been waiting for their results and are worried about their lifestyle and independence.

However, as frightening as these terms sound, they’re 100% treatable and will heal!

The discs in your spine hold fluid and the amount of fluid can depend on what time of day it is or when you’re sick with a cold or flu. But these discs can become injured, much like an ankle sprain.

Over time and with treatments like physical therapy, strength training, and continued physical activity the swelling in your discs will calm, movement will improve and you will be able to return to activities you once loved like walking, playing with the grandkids in the garden, or even booking yourself a holiday!

Do You Need Some Expert Advice For Your Back Pain?

Have you been suffering from back pain that’s stopping you from completing daily activities, getting out for your exercise, or making you worry about the future?

You’ve come to the right place!

Here at Pain and Performance Clinic, we’re passionate about getting you back to doing the activities you love without pain and aches taking over your life.

Right now, we’re offering you the chance to book a free back pain telephone consultation where you can speak to one of our expert physiotherapists about your pain problems, ask your important questions and get clarity from the answers!

If you’ve had enough of back pain ruining your life, your independence and your future, arrange a free back pain telephone consultation by calling our Lucan clinic at 086 787 6358.

Other Free Resources For Back Pain

Read Our Blog – What Is Osteopenia/Osteoporosis?

Read Our Blog – Do You Have Pain That Won’t Go Away?

On Social Media? Follow Us On – Facebook, Instagram, YouTube

Shockwave Therapy For Plantar Fasciitis: How It Can Help You!

Are you suffering from plantar fasciitis and you’re not able to continue your workouts or even just get to the shops?

If so, you’re definitely not alone! Plantar fasciitis affects many people and can cause extremely painful inflammation in the heel.

Fortunately, there are a number of treatments that may help relieve your discomfort. One such treatment is shockwave therapy — an innovative form of therapy that has been found to be an effective and safe approach for treating plantar fasciitis.

In this blog post, we’ll explore how it works, why it’s so popular among medical professionals for addressing this condition, and what potential benefits it could hold for those who suffer from plantar fasciitis.

So read on to discover if shockwave therapy is the right choice for you!

What Is Plantar Fasciitis And How Can Shockwave Therapy Help?

Plantar fasciitis is a common condition that affects many individuals, causing discomfort and pain in their feet.

It occurs when the tissue that connects the heel to the toes becomes inflamed, making it difficult for people to move around without experiencing discomfort.

Despite being a common condition, many people struggle to find effective treatments for plantar fasciitis. That’s where shockwave therapy comes in.

With its non-invasive nature and incredible results, shockwave therapy has become a popular treatment option for plantar fasciitis.

By using high-frequency sound waves, shockwave therapy helps to stimulate blood flow and speed up the healing process. It’s an efficient, pain-free option that has been proven time and time again to make a difference in individuals’ lives.

What Are The Benefits Of Shockwave Therapy for Plantar Fasciitis?

Shockwave therapy for plantar fasciitis can help to alleviate the dreaded pain you feel whenever you stand or walk.

The decrease you experience in pain is the gateway to be able to increase your range of movement allowing you to do more of the activities you love and begin the healing process.

Traditional types of treatment such as steroid injections and scary surgeries are very high risk and you may go through these risky treatments, have a long recovery time and it may only temporarily solve the problem.

Shockwave therapy is very low risk with little to no side effects and often patients see a faster recovery time with fewer sessions than it would take using traditional treatments.

What To Expect During A Shockwave Therapy Session

An average course of shockwave therapy for plantar fasciitis will consist of just 4-6 sessions with no more than two weeks between each session so the treatment can work faster.

A typical session lasts around 15-20 minutes and includes an assessment, your all-important treatment, and aftercare advice from our expert physiotherapists who can set you on the right track to build your strength up again!

What To Expect After A Shockwave Therapy Session

After a shockwave therapy session, you can expect to be prescribed exercises by our physiotherapists which aim to help you strengthen your foot and be able to get back to your daily routine without causing further damage to your foot.

It’s important to note, high-impact exercise including running and jumping should be avoided for 48 hours following a shockwave therapy session as it could impact the healing process, which we know you don’t want to do!

Think Shockwave Therapy Could Help You Recover From Plantar Fasciitis?

If you’ve been having foot problems that are preventing you from hitting the gym or going out running with friends, you could be suffering from an injury such as plantar fasciitis, and the longer you leave it without seeking help, the worse it will become!

That’s why we’re currently offering a free foot pain assessment where you can get help and advice about your foot pain and see if you qualify for shockwave therapy treatments.

To finally get back to the gym and hit your personal bests again without pain, arrange your free foot pain assessment today by calling our Lucan Clinic at 086 787 6358 or emailing us at we’ll look forward to seeing you in our clinic soon!

Other Free Resources For Plantar Fasciitis

Read Our Blog – Plantar Fasciitis – Symptoms, Causes & Treatments

Read Our Blog – Do You Have Pain That Won’t Go Away?

On Social Media? Follow Us On – Facebook, Instagram, YouTube 

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