Heel Pain

Plantar Fasciitis is the most common cause of heel pain and also the most common condition presenting to our clinic. That being said, heel pain is a very complex condition that needs to be correctly diagnosed and treated specific to each person.

The plantar fascia is a thick fibrous band of tissue in the bottom of the foot which runs from the heel to the base of the toes. When placed under increased stress, the plantar fascia can stretch and tear, resulting in degeneration of this tissue, particularly at its insertion into the heel bone, causing heel pain. In some cases the pain is also felt in the arch. The tears are soon covered by scar tissue, which is less flexible than the fascia and hence aggravate the problem. Continuous straining of the fascia at the heel bone may eventually lead to the development of bony growth on the heel (heel spur).

In majority of cases of heel pain, the heel spur is NOT the cause of the pain. The pain is due to the degeneration and weakening of the soft tissue (Plantar Fascia), regardless of whether a heel spur is present or not.

Signs & Symptoms

• Pain on the sole of the foot, often localised to the front of the heel
• Heel pain is usually worse the first few steps in the morning and after rest periods during the day
• Heel pain often aggravated by prolonged standing, walking or running, especially on hard surfaces
• As the condition progresses, patients may experience burning, numbness and throbbing around the heel when resting at night

Causes

• Over-pronation (arch collapse)
• Tight calf muscles and achilles tendon
• High arches and rigid feet
• Barefoot on hard surfaces or incorrect or worn out shoes
• Jobs that require lots of walking on hard surfaces
• Over training or sudden increase in training
• Weight gain

Treatment

Treatment for plantar fasciitis involves stretching and warming the foot up before walking in the morning and after rest periods.

Further treatments will depend on your individual condition:

• Arch strapping to decrease the strain on the plantar fascia
• Further calf, achilles tendon and arch stretches
• Foot strengthening exercises
• Heat, arch massage, Western medical acupuncture, laser therapy and other forms of physical therapies
• Reduce training load and intensity (try alternative exercises like swimming, cycling and upper body weights which have less impact on the feet)
• Footwear changes (correct support and midsole cushioning, small heel height)
• Customised Foot Supports (Orthotics) to reduce over-pronation and cushion the heel
• Shockwave therapy to accelerate body's self-healing process
• Night socks or splints to improve ankle flexion
• Moonboot to further immobilise foot and reduce strain on plantar fascia
• Cortisone injection into the site is generally not recommend as the cortisone may weaken the already-weakened, injured site
• In very few cases surgical intervention is necessary

Heel pain is a very common condition yet complex in nature, where a 'one size fits all treatment approach' often fails. An accurate diagnosis is important to prescribe the most suitable treatment plan.

Don’t let heel pain slow you down – give Foundation Podiatry a call today!