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)
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
Spending prolonged time on hard surfaces (concrete, AstroTurf etc)
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)
Hormonal and other physiological changes
Muscle tightness and tension
A pronated ‘flat’ foot posture
What else could it be?
Not all heel pain is plantar fasciitis. Here are some other common conditions associated with heel pain:
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
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