Rojak salad is a sour, spicy and sweet south-east Asian staple. It can be made vegan by taking care to buy a samba oelek, an Indonesian chilli sauce, without shrimp paste either on-line or from an Asian food store
Rojak salad is an Indonesian, Malay and Singaporean mainstay that to me always felt like a dish you’d serve at a retro dinner party. It’s often studded with tropical fruit, such as pineapple, packed with deep-fried dough and tofu, and covered in a sweet, syrupy tamarind sauce.
But Claire Thomson’s version in her latest book, New Kitchen Basics takes the idea and turns it into a fresh, light, flavourful and easy salad. This is an adapted version, using avocado and apple. It is sour, hot and sweet, but not too sweet. It’s a keeper – and a new kitchen favourite.
Prep 20 min Cook 8 min Serves 4
2 tbsp tamarind paste 2 tsp vegan sambal oelek, or to taste – I like the Lucullus brand 1 tbsp brown rice syrup or maple syrup 3 tbsp light soy sauce Rapeseed oil 1 x 280g pack extra-firm tofu, drained and cut into cubes ¼ white cabbage, finely shredded (150g net) ½ cucumber, deseeded and cut into thin slices 100g baby leaf spinach 2 Braeburn apples, cut into 2mm slices 2 avocados, stoned and cut into wedges (250g net) 1 handful fresh mint leaves, torn from about 4 sprigs 100g peanuts or hazelnuts roasted, salted and ground Lime wedges, to serve
First, make the dressing. In a small bowl, whisk the tamarind paste, sambal oelek and syrup with two tablespoons of the soy and a tablespoon of oil. Taste the dressing, making sure you’re happy with the balance of heat, sour, sweet and salt, and adjust as required.
Heat a tablespoon of oil in a frying pan over a medium heat and, when hot, fry the tofu cubes for six to eight minutes, turning them with tongs, until golden brown all over, then add the remaining tablespoon of soy, take off the heat and tip into a serving bowl.
Add the cabbage, cucumber, spinach, apple, avocado wedges, mint leaves and half the nuts to the bowl, then toss with your hands to wilt the spinach and mash the avocado a little. Add about six tablespoons of the dressing, mix again, then taste and add more dressing if need be. Garnish with the remaining peanuts and serve with a lime wedge on the side.
It’s Spring and the garden is lovely. The seasons are clearly out of whack though with everything a few weeks ahead of time.
The crocus and daffodils came and went along with the camellia and magnolia and the pear blossom. The blue muscari and white anemone (a good buy last year) have worked well and led into the tulips. After two years, the iris finally started to flower though not all of them. The white clematis is in full bloom and the glory of the wisteria and the bluebells are currently dominating.
The tulips have just gone over, except under the maple tree where the yellow flowers planted last year are looking good. I shall have to plant more of them, and maybe some of the orange ones. The latter are a lovely shade but only around 10cm tall so really only good for the very edge of the bed.
At the moment I’m waiting for the alliums to burst into life. A couple of sprinkles of slug pellets seem to be keeping the worst of the snails at bay. Hopefully the roses will follow straight after. Even though I am totally sure they were measured out very precisely, the soft pink roses seem to have broken into three groups of three rather than a consistent hedge of nine. My gardener seems to have cut back the penstemnon a bit brutally – I’ll be cross if it means I’ve lost it.
Hopefully the baby white roses in the front will grow more evenly. The salvia planted between them looks to have survived but the bed is still a bit overgrown. I wonder if the foxgloves from last year have self seeded – as a biannual they’ll just grow green this year so it will be tempting to dig them out.
I have already planted up pots and tubs with geraniums, begonias and lobelia. And possibly for the last year I’m attempting to keep alive two hanging baskets. I know the answer is to water the beggars, but despite my best intentions, I never make it much past a month.
In a few weeks I shall have to buy some more white bedding, snapdragons maybe or alyssum, to replace the anemones at the front of the bed but right now, I’m busy watering and generally babying some pots ready to distribute them around the darkest and driest bits of my garden.
Having invested in a bundt tin, I’ve started looking for recipes that taste as well as the tin looks. This recipe makes a hearty spice-filled bundt made from grated apples and toasted nuts, then soaked in whiskey syrup. Plus, a bundt cake, which is really just like an oversize muffin baked in a fancy pan, is easy to whip up. The booze bath helps keep it fresh, meaning you can bake it ahead and eat the leftovers for days.
Practical and pretty.
INGREDIENTS
2sticks unsalted butter 226 grams, at room temperature, plus more to grease pan
2 ½cups plain flour 315 grams, plus more to dust the pan
3tablespoons (30 grams) whiskey
½cup (90 grams) candied ginger, chopped
1 ¾cup (330 grams) light brown sugar
4large eggs, at room temperature
2teaspoons (8 grams) baking powder
1teaspoon (5 grams) bicarbonate of soda
1 ½teaspoons (3 grams) ground cinnamon
1teaspoon (5 grams) fine sea salt
½teaspoon grated nutmeg
1cup (227 grams) sour cream or yoghurt
1tablespoon (15 grams) vanilla extract
1 ½teaspoon (5 grams) finely grated lemon zest
2medium Granny Smith apples about a pound, 454 grams, peeled, cored, and coarsely grated
1cup (120 grams) finely chopped, toasted pecans
½cup (100 grams) granulated sugar
Juice of 1/2 lemon (20 grams)
1/2 cup whiskey (20 grams)
PREPARATION
Heat the oven to 325 degrees. Grease and flour a 12-cup bundt pan. In a small bowl, combine 3 tablespoons whisky and the candied ginger. Let stand 10 minutes.
In the bowl of an electric mixer fitted with the paddle attachment, beat together the brown sugar and remaining butter on medium-high speed, until light and fluffy, about 5 minutes. Beat in the eggs, 1 at a time, until incorporated.
In a separate bowl, whisk together the remaining flour with the baking powder, baking soda, cinnamon, salt and nutmeg. In a separate bowl, whisk together the sour cream and vanilla. Pour in the bourbon from the ginger mixture (reserve ginger) and whisk until smooth. Stir in zest.
With the mixer on medium speed, add the dry mixture and sour cream mixture to the wet mixture in three additions, alternating between the two. Fold in the ginger, apples and pecans. Scrape the batter into the prepared pan. Any excess can be used in muffin tins and baked for around 20 minutes in the oven with the cake.
Bake until the cake is golden brown and a skewer inserted into the cake comes out dry, about 1 hour 10 minutes. Cool in the pan 20 minutes, then run a paring knife around the sides of the pan to release the cake; cool, flat side down, on a wire rack.
While the cake cools, combine the 1/2 cup granulated sugar and 1/2 cup whiskey in a small saucepan. Over low heat, gently stir until the sugar dissolves. Stir in the lemon juice and take off the heat.
Make sure the cake is loose enough to release fully from the tin. Poke holes in the flat bottom of the still-warm cake, pouring half of the whisky glaze on the bottom and letting it sink in. Flip the cake out of the tin.
While the cake cools, make 10 slits on top with a paring knife and pour the remaining half the bourbon-sugar mixture on the still-warm cake.
PS I’ve included the whole recipe as I received it, but there’s quite a lot going on flavour wise.
Depending on what you have in the cupboard you could lose any (but not all of) the whisky, lemon, ginger, vanilla, apples or pecans.
Including the first three only tastes a bit like a whisky toddy whilst including just the last three (vanilla, apples or pecans) feels more of a wholesome family cake. Whisky/pecan is also good combination.
The first tennis match of the year is approaching and it’s at home leading to the “forever” question of what to make for supper.
An onion tart with a cream cheese base or something more Italian in feel?
Three hefty salads, with or without a second tart? New potatoes and asparagus with mint or a version of aloo papri chaat? Ceviche broccoli with cavalo nero or some other form of green, maybe a farmer’s salad? Or what about some form of sticky butternut squash or tofu salad with aubergine with a soy dressing?
Someone else can bring desert and something to drink.
Or I could throw the pattern out and make a huge butternut squash laksa or curry with some rice and vegetable salads as sides. My partner could bring the food down to the club just before we’re ready to eat at 9pm.
My entire family is vaccinated against most common illnesses but that wasn’t always the case.
We didn’t routinely vaccinate or get the standard baby batch vaccinations and even now, there are some that I probably wouldn’t bother with if they weren’t part of a batch vaccine with something more useful.
As long as we’re in the UK, polio is pretty much pointless as a vaccination since it’s a disease eradicated from our country, though it was one we signed up to straight away once we started traveling around the world with the kids.
Pertussis or whooping cough has a vaccine with limited efficacy requiring a booster shot every 4-5 years but since it’s part of the DTP shot, we keep up to date with it.
There are some other vaccines that just aren’t very effective such as the flu vaccine so the elder members of our family have thought hard about using them. At the end of the day, there are just too many versions of flu around for any shot to cover everything but the downsides to this vaccine are low to non-existent side-effects outweighed by any coverage to catching flu so it’s worth having the shot for the elderly.
Standard UK vaccinations include diphtheria, tetanus, whooping cough (DTP) polio, Hib (Haemophilus influenzae type b) and hepatitis B. My daughters, like most girls in the UK, are also vaccinated against HPV. Since we’ve all caught chickenpox, we should have lifelong immunity.
Travel vaccinations that we’ve also added to our list include HepA and obviously we all take antimalarials where necessary.
We have never fallen sick (beyond my uncomfortable food poisoning in Laos travelling up the Mekon) and considering that we’ve been visiting developing countries since our kids were toddlers, that’s a pretty good outcome.
It’s something we attribute in large part to decent preventative measures such as basic hygiene i.e. eating only hot cooked food, hot drinks, bottled water for drinking and brushing of teeth, water purifying tablets if required etc. and the use of preventatives such as nets over beds, insecticide sprays around rooms, and ones designed to sprayed on the body as well as basic long sleeves and trousers. It’s pretty simple stuff bit always surprising to find out how many people seem to get it wrong.
I’m not convinced that I’d vaccinate my kids if I didn’t think there was a direct risk of them catching the diseases listed i.e. if we weren’t travelling. Herd immunity, the protection of other people’s kids, is a cold reason to stick a needle into your baby and I’m just selfish enough for it not to weigh too heavily.
But the risk of catching one of these diseases is very real given the places we travel and the results of catching those disease can be horrendous, so we vaccinated.
Other, better, less selfish parents should vaccinate immediately. They work 85-95% of the time. The vaccine side effects are minimal whilst the effects of catching the diseases themselves can be devastating. Your baby will cry, possibly scream, when they get the shot but that can be countered with an ice cream. They may even have a slight temperature which will need some calpol (baby paracetamol). These symptoms are nothing compared to the actual symptoms of any of these diseases.
As the cases of measles rise in the UK, it’s worth remembering the symptoms. Measles lasts 7-10 days, starting with flu like symptoms, a runny or blocked nose, sneezing, watery eyes and swollen eyelids, sore and red eyes, a high temperature of upto 40C, small greyish spots in the mouth, cough, no appetite, tiredness, irritability and a general lack of energy.
This is followed by a rash around 2 to 4 days after initial symptoms.
Complications can include liver infection, misalignment of the eyes if the virus affects the nerves and muscles of the eye infection of the membranes surrounding the brain and spinal cord or infection of the brain itself.
Some children will die from contracting measles. A vaccine is a small price to pay to reduce that risk for my kids.
This salad is a mix of textures and flavours: crispy, creamy paneer with sweet mango and golden shallots with tart tamarind – all strewn atop a bed of fresh leaves and herbs. Semi-ripe mangoes are best for this salad.T
Heady mix: Paneer and mango salad with tamarind and shallots
Serves 4 For the dressing 2cm piece of ginger, peeled and roughly chopped 1 green chilli Salt Juice of 1 lime 1 tbsp honey Rapeseed oil
For the salad 500g paneer, diced into 1.5cm cubes 200g banana shallots (or 4 big ones) 2 x large mangoes, peeled and cut into 1.5cm cubes 2 tsp tamarind paste 120g mixed leaves 15g mint leaves, chopped 20g fresh coriander, chopped
1 To make the salad dressing, add the ginger and chilli to a pestle and mortar along with ¼ teaspoon salt. Bash until the chilli and ginger have broken down, completely then add the lime juice, honey and 2 tablespoons of rapeseed oil. Mix and set aside.
2 Heat a large pan on a high heat, and add about 2 tbsp oil. When hot, fry the paneer, turning the pieces frequently to brown them on all sides. Watch out as the paneer might spit; half cover with a lid to protect yourself if so. When golden and crispy, transfer to a paper-towelled dish.
3 Add the shallots to the same pan (adding more oil to cook if needed) and cook for around 6-8 minutes until soft and starting to brown. Then add the paneer back in alongside the mango, tamarind paste and ¾ teaspoon salt. Stir to mix and take off the heat.
4 In a serving bowl, add the leaves and chopped herbs and, just before serving, tip in the paneer and mango mixture and the salad dressing. Toss together and serve with warm naan or a good bread.
For a very very wet country, Iceland felt very similar to some of the many deserts we’ve visited over the years.
Lava Fields with moss, Iceland
In large part, though for obviously different reasons, it felt very barren and obviously very empty. The almost complete lack of anyone else around us as we made our way around the country still surprises.
Driving through the uplands, across the lava fields with nothing and no one in sight, just reminded us of countless drives across the salt flats of Etosha, Namibia or Uyuni, Bolivia
Or long ago, across the desert in Yemen.
We even found the remains of trees, very reminiscent of Namibia. Iceland was essentially deforested with the original influx of people from Scandinavia.
Perhaps it was just the scale of the landscape, the huge empty spaces and vast skies.
But there was also a surprising overlap in terms of the cliffs in the Negev and the cliffs of Iceland.
Negev cliffsIceland cliffsNegev Cliffs
Or even the mountains of the Yemen or Namibian hills.
Yemen
And obviously there are signs of volcanic activity across many of the parts of the world we’ve visited.
Basalt columns, South Iceland Negev, Basalt ColumnNamibia Basalt
Even the glaciers reminded me of the dunes carving their way through the African landscape.
There is something mesmerising about empty landscape, something very very beautiful. I’m not sure many of us would be comfortable in that stark landscape, aside from the obvious difficulties of surviving the environment but it’s certainly an environment plenty of us find very satisfying to visit.
Turns out that the best explanation of my personal experience of the brexit process so far is the five stages of grief. Obviously it is neither sensible nor appropriate to equate a political decision to the personal loss of a loved one, but the process of coming to terms with brexit does seem to be moving through the same five stages
DENIAL
Denial is the first of the five stages of grief and brexit – surely this cannot be happening? There has to be some sort of mistake. In this stage, the world became somewhat meaningless and overwhelming. Life mades no sense. We were in a state of shock and denial. Numb. Initially the focus was just on finding a way to get through the day. Denial and shock help us to cope and make survival possible by helping us to pace our feelings of grief. There is a grace in denial. As you accept the reality of the loss and start to ask yourself questions, you begin the healing process. You are become stronger, and denial is beginning to fade. But as you proceed, all the feelings you were denying begin to surface.
ANGER
Anger is a necessary stage of any healing process. Be willing to feel your anger, even though it may seem endless. The more you truly feel it, the more it will begin to dissipate and the more you will heal. There are many other emotions under the anger and you will get to them in time, but anger is the emotion we are most used to managing.
The truth is that anger has no limits. It can extend not only to your friends, the doctors, your family, yourself and your loved one who died, but also to God. You may ask, “Where is God in this? Underneath anger is pain, your pain. It is natural to feel deserted and abandoned, but we live in a society that fears anger. Anger is strength and it can be an anchor, giving temporary structure to the nothingness of loss. At first grief feels like being lost at sea: no connection to anything. Then you get angry at someone, maybe a person who didn’t attend the funeral, maybe a person who isn’t around, maybe a person who is different now that your loved one has died. Suddenly you have a structure – – your anger toward them. The anger becomes a bridge over the open sea, a connection from you to them. It is something to hold onto; and a connection made from the strength of anger feels better than nothing.We usually know more about suppressing anger than feeling it. The anger is just another indication of the intensity of your love.
BARGAINING
After a loss, bargaining may take the form of a temporary truce. “What if we hold a second referendum. Then can I wake up and realize this has all been a bad dream?” We become lost in a maze of “If only…” or “What if…” statements. We want life returned to what is was; we want our life and country restored. We want to go back in time: find the political tumor sooner, recognize the illness more quickly, stop the accident from happening…if only, if only, if only.
Guilt is often bargaining’s companion. The “if onlys” cause us to find fault in ourselves and what we “think” we could have done differently. We may even bargain with the pain.
We will do anything not to feel the pain of this loss. We remain in the past, trying to negotiate our way out of the hurt. People often think of the stages as lasting weeks or months. They forget that the stages are responses to feelings that can last for minutes or hours as we flip in and out of one and then another. We do not enter and leave each individual stage in a linear fashion. We may feel one, then another and back again to the first one.
DEPRESSION
After bargaining, our attention moves squarely into the present. Empty feelings present themselves, and grief enters our lives on a deeper level, deeper than we ever imagined. This depressive stage feels as though it will last forever. It’s important to understand that this depression is not a sign of mental illness. It is the appropriate response to a great loss.
We withdraw from life, left in a fog of intense sadness, wondering, perhaps, if there is any point in going on alone? Why go on at all? Depression after a loss is too often seen as unnatural: a state to be fixed, something to snap out of.
The first question to ask yourself is whether or not the situation you’re in is actually depressing. The loss of a loved one is a very depressing situation, and depression is a normal and appropriate response. To not experience depression after a loved one dies would be unusual. When a loss fully settles in your soul, the realization that your loved one didn’t get better this time and is not coming back is understandably depressing. If grief is a process of healing, then depression is one of the many necessary steps along the way.
ACCEPTANCE
Acceptance is often confused with the notion of being “all right” or “OK” with what has happened. This is not the case.
Most people don’t ever feel OK or all right about the loss of a loved one. This stage is about accepting the reality that our loved one is physically gone and recognizing that this new reality is the permanent reality. Thus people who voted to remain in the EU may well accept that we’re leaving but they won’t ever be ok with leaving and will never like this reality. We may learn to live with it. It is the new norm with which we must learn to live.
In resisting this new norm, at first many people want to maintain life as it was before a loved one died. In time, through bits and pieces of acceptance, however, we see that we cannot maintain the past intact. It has been forever changed and we must readjust. We must learn to reorganise. Finding acceptance may be just having more good days than bad ones.
An Egyptian pudding popular across the Arab world, a bit like a bread-and-butter pudding. Instead of flatbread, pieces of baked pastry can also be used, as I do here.
Prep 10 min Infuse 1 hr+ Cook 1 hr 25 min Serves 4-6
700ml whole milk 300ml double cream 15 cardamom pods, roughly bashed open in a mortar 2 cinnamon sticks 125g caster sugar 6 feuilles de filo pastry (120g) 60g unsalted butter, melted 2 tsp runny honey 40g pine nuts 30g flaked almonds 1½ tsp white sesame seeds 1½ tsp black sesame seeds 1 tsp olive oil 1 tsp rose water 1 pinch flaked sea salt 30g desiccated coconut, lightly toasted ½ tsp ground cinnamon 20g pistachio kernels, finely chopped 1½ tbsp barberries, soaked in hot water for 20 minutes, then drained
Heat the oven to 170C (160C fan)/350F/gas 4. Put the milk, cream, cardamom and cinnamon in a medium saucepan, turn on the heat to medium-low, cover and cook for 20 minutes, or until steaming and just beginning to bubble. Turn off the heat and leave to infuse for at least an hour (or refrigerate overnight). Strain through a sieve set over a bowl (discard the solids), then pour back into the pan and add 70g sugar. Bring to a simmer on a medium heat, stirring from time to time, then set aside and keep warm.
Lay out one filo sheet on a clean work surface and brush liberally with melted butter and a teaspoon and a half of caster sugar. Top with another sheet of filo and repeat until you’ve used up all the filo and melted butter and 45g of the sugar. Transfer to a large oven tray lined with greaseproof paper and bake for 20 minutes, until golden. Remove from the oven, set aside to cool, then break into jagged, roughly 10cm pieces; it’s fine if they flake apart a little.
Put the honey, pine nuts, almonds, sesame seeds, oil, rose water and a pinch of flaked sea salt in a small bowl and mix well. Transfer to a small oven tray lined with greaseproof paper, bake for eight minutes, then stir and bake for four minutes more, or until golden. Remove from the oven, leave to cool for 10 minutes, then break into small clusters.
Turn up the oven to 190C (180C fan)/390F/gas 6. To assemble the dish, arrange half the baked filo pieces in a 24cm-long x 14cm-wide x 7cm-deep baking dish, and sprinkle over half the coconut and a quarter-teaspoon of cinnamon. Top with the remaining filo, then pour over the warm milk. Sprinkle with the remaining quarter-teaspoon of cinnamon, the remaining coconut and the last 10g of sugar. Bake for 25 minutes, or until golden and bubbling, then remove from the oven and leave to cool for about 15 minutes. Top with the pistachios, barberries and pine nut clusters, and serve warm.
Rolling over in bed before going to sleep should not result in stabbing pain in your heel, yet apparently it’s a thing, plantar fasciitis, for a moderately active woman of a certain age.
Just to re-state the obvious: menopause is crap. Growing old is not for wimps.
A few different factors can lead to heel pain, including sciatica and the heel version of carpel tunnel syndrome but one of the most common causes is plantar fasciitis.
Luckily self-care treatments can help reduce the pain and inflammation linked to plantar fasciitis so I’m going to try the obvious before panic sets in.
The following treatments are available to self-administer at home:
Ice: Advice is to apply ice three or four times a day for about 15 minutes at a time. It’s advisable to wrap an ice pack in a damp towel and place it on the heel. Since ice seems to be making things feel worse (though it is the best advice) I’m going to try relaxing with heat packs as well. My coach recommends an alternating sequence of heat and ice.
Non-steroidal anti-inflammatory drugs (NSAIDs): NSAISs may also help reduce discomfort and inflammation. Ibuprofen and paracetamol combined are my go-to pain relief so they’re definitely on the menu for the next few days
Orthotics: Foot orthotics are custom foot supports to places them in the shoes. Orthotics can support the arch, which helps evenly distribute the weight placed on the heel when a person walks. But since I spend my life in flats, and definitely use decent sports shoes, I’m going to passion these for now
Splint: Wearing a splint at night might also help. The splint stretches the arch and calf, and may decrease discomfort. At the moment this sounds like more trouble than it’s worth.
Switching activities: It might also be helpful for people to switch from high-impact activities, such as running, to exercise that is easier on the heel. Low-impact options include swimming and walking. Since I hate these and love tennis, this just isn’t going to happen
Exercises
Certain stretches can help heel pain.
Plantar fasciitis can disrupt workout routines.
Continuing to partake in certain activities can make heel pain worse, but remaining idle and avoiding exercise is not beneficial.
Exercise is still possible when dealing with plantar fasciitis. The key is to avoid activities that place a lot of force on the heel.
Stretches for plantar fasciitis
According to the American Academy of Orthopaedic Surgeons, certain stretches can help reduce heel pain and prevent plantar fasciitis from reoccurring.
People who have plantar fasciitis pain in the morning might want to carry out the following stretches as soon as they wake up.
Seated Fascia Stretch (this worked like a miracle of pain relief for as long as I held the stretch)
Sit in a cross-legged position at the end of the bed or a chair.
Place the affected foot over the knee of the other leg.
Grab the heel of the painful foot with one hand and the toes with the other hand.
Gently pull up on the toes, while at the same time pulling up on the heel. Bending the toes up stretches the fascia.
Bending the ankle up stretches the Achilles tendon, which may help decrease pain.
Hold the stretch for about 10 seconds.
Relax the foot and repeat 10 to 20 times. If both feet are experiencing pain, repeat the exercise on the other foot.
Seated Ankle Pumps (this hurt like hell a few times into the repetition)
Sitting in a chair, hold the leg out straight and flex and extend at the ankle joint.
This exercise stretches both the fascia and the calf muscle.
Hold the stretch for 5 seconds and repeat 10 times on each foot.
Standing Calf Stretch (felt it in my calf but not the heel)
Place both hands on a wall, keep the back leg straight, and place the heel down.
Pull the hips forward towards the wall until the stretch is felt in the back of the lower leg.
Hold for 10 seconds and repeat several times.
If the heel on the opposite leg hurts, repeat the stretch on that leg too.
Medical treatment options
Although home treatments can be enough to decrease heel pain from plantar fasciitis, they might not always have the desired effect.
If home treatment is not successful, a doctor might recommend additional medical treatments, such as:
Steroid injections: When heel pain persists, steroid injections are an option. The doctor injects an anti-inflammatory steroid medication into the heel. Frequent steroid injections can weaken the fascia, so injections cannot be given too frequently.
Surgery: This can be a possible last resort. There are several different surgical procedures for reducing heel pain. For example, a procedure called a plantar fascia release involves partially cutting the fascia to reduce the tension of the tissue.
Visiting a physiotherapist worked with tennis elbow (from housework rather than tennis) so I may make some appointments with my local recommended physiotherapist to see if she can work on my heel. I’ll certainly try this long before I visit the doctor for injections or the hospital for surgery.
Causes
The plantar fascia is a ligament that runs underneath the soles of the feet. It connects the heel bones to the front of the feet and also supports the arch.
The fascia normally serves as a shock absorber, but repeated stress to the heel can lead to small tears in the tissue. This tissue damage causes inflammation in the fascia known as plantar fasciitis.
There are a few different causes of plantar fasciitis. The ligament can become inflamed due to repeated force from high-impact activities and sports that involve a lot of jumping. Wearing high heels may also place stress on the fascia.
Having a job that requires a lot of standing or walking increases the chances of developing the condition. People with flat feet may also be more likely to develop plantar fasciitis. Flat feet can cause an uneven distribution of weight when someone walks, which puts added stress and pressure on the fascia.
Prevention
Choosing comfortable shoes can help reduce symptoms of heel pain.
Stretching can be helpful in decreasing the symptoms of plantar fasciitis and also preventing the condition from developing. In addition to stretching, a few steps might help prevent plantar fasciitis.
People can start by wearing the right shoes. Avoid high heels as they can place stress on the heel. Shoes with a moderate heel and sturdy arch support can help.
Be sure to always wear footwear and avoid being barefoot for long stretches of time. The lack of support could lead to heel pain.
Athletic shoes provide good support and cushion the feet. A 2011 study suggests that running or athletic shoes should be replaced every 500 miles. Start exercise slowly and gradually increase intensity to prevent plantar fasciitis.
Symptoms
The most common symptom of plantar fasciitis is pain in the heel and sometimes the arch of the foot.
The pain usually starts mild, and people often feel it when stepping out of bed in the morning, as well as after sitting for a long period. Although pain levels can vary, discomfort often decreases after walking around for a while.
The pain from plantar fasciitis can last a long time, and complications can develop. Continued inflammation of the fascia can lead to the development of scar tissue. This can make the condition harder to treat.
Plantar fasciitis can also cause pain elsewhere in the body. For example, when someone has heel pain, they might adjust the way they walk without realizing it.
Knee, hip, and back problems can develop due to changing body movements.
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