Plantar Heel Pain

Updated: Mar 30

Plantar heel pain encompasses all musculoskeletal conditions that cause pain to the bottom of your foot and heel. One of the most common causes of plantar heel pain is plantar fasciitis. If left untreated, plantar fasciitis can progress, resulting in severe impairment and debilitation of foot function and daily living.


What is plantar fasciitis?


Plantar fasciitis is the inflammation and irritation of your plantar fascia – a thick band of fibrous tissue that lies directly beneath the skin on the bottom of your foot. This band starts from the heel and fans out to connect into each of the toes. This means pain can be experienced anywhere along the length of the structure, such as:


  • Directly under the heel (insertional pain)

  • Arch pain/midfoot pain (non-insertional pain)

  • Diffuse/generalized pain


Common characteristics and symptoms:

  • A gradual onset of pain occurring in one or both feet.

  • The pain can feel like a dull ache or a stone bruise. It may also present as a sharp stabbing pain or ‘stiffness/tension’ in the arch area.

  • Pain when you take your first step in the morning or after periods of non-weightbearing.

  • Pain after periods of activity (e.g., running or being on your feet all day).


What causes plantar fascia pain?

Plantar fascia irritation is caused by the imbalance between load (stresses being placed on the foot), and capacity (how the foot deals with these stresses).


1) The load has increased due to:

  • A rapid increase in training or activity levels

  • The commencement of a new activity

  • Long periods of standing at work

  • Inappropriate footwear

  • Spending prolonged time on hard surfaces (concrete, AstroTurf etc)

OR


2) The capacity has decreased (if load hasn’t changed due) due to:

  • Psychological factors (being down/stressed can make you more susceptible to injuries)

  • Age

  • Hormonal and other physiological changes

  • Muscle tightness and tension

  • A pronated ‘flat’ foot posture

  • High BMI


What else could it be?

Not all heel pain is plantar fasciitis. Here are some other common conditions associated with heel pain:

  • Achilles Tendinopathy

  • Retrocalcaneal bursitis

  • Severs (calcaneal apophysitis)

  • Posterior tibial tendon pain

  • Tarsal tunnel syndrome

  • Fat pad atrophy/injury


Treatment for plantar fasciitis at home may help ease symptoms initially.

Below are some easy things you can try:

  • Rest/reducing the load on the fascia

  • Rolling your foot on a frozen water bottle or tennis ball

  • Self-massage with topical anti-inflammatories (i.e., Voltaren gel)

  • Avoiding bare feet and inappropriate footwear

  • Stretching your calf muscles

Treatment from one of our podiatrists will help to identify and address the root cause of your pain. Here are some treatments we may do:

  • A comprehensive assessment and diagnosis (doctor google isn’t always correct!)

  • Strapping to support the arch and reduce strain and stress along the fascia

  • A stretching and strengthening program to improve lower limb and fascial function

  • Provide footwear recommendations based on your foot type and function

  • Administer orthotic intervention to address underlying biomechanical causes and reduce load through the irritated structures

  • Shock wave therapy

  • Referrals for imaging, blood tests, and other specialist care

Need an appointment? Book online here today!

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