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Home / Heel Pain & Plantar Fasciitis

The plantar fascia is a strong fibrous band of tissue that links the heel bone to the toes.  It has a important role of maintaining the integrity of the arch of the foot, acts as a shock absorber and aids in the pushing off phase of the walking cycle.

It has been reported and predicted that the plantar fascia is loaded 1.8-3.7 times of the body’s weight during walking and running. (Giddings et al 2000).

Symptoms

Pain typically occurs when the plantar fascia becomes injured or inflamed on the inside of the heel and under the arch.  Patients often described as a dull ache or throb which is worse in the morning when getting out of bed or after sitting down.  Gentle exercises and walking often eases symptoms, with symptoms then returning after walking or running.

Top Causes of Heel Pain:

Trauma or Injury

One single major direct trauma onto the underside of the foot or repeated microtrauma from a lump or bump in the shoe can irritate the fascia.

Increase in Activity or starting a new sport
A sudden increase in intensity in a sporting activity or non-sport related activity can place an increased amount of pressure through the fascia.

Being Overweight
Research reports up to 80% of patients who present in the clinic are overweight, carrying increased weight puts more strain through the feet, weight loss plays an important role.

Shoes
Flat and unsupportive footwear, i.e., prolonged use of flip-flops in the summer can cause an increased stress on the plantar fascia.

Abnormal biomechanics

This can cause the plantar fascia not to function correctly and cause increased stress through the fascia.

Tight calf muscles
having tight calf muscles can put increased strain on the plantar fascia as it becomes increasingly loaded during walking and running.

Referred Pain
Referred pain from the lower back can give symptoms within the heel and foot.

Diagnosis

Diagnosis tends to be clinical, based on history/activity and symptoms followed by an assessment. This  can provide a very accurate diagnosis. Occasionally imaging is used to confirm diagnosis. Ultrasound examination is excellent for this purpose as it is quick and sensitive. It assesses the thickness of the plantar fascia as it arises from the heel bone, it can identify any tears or ruptures.

Treatment
Home Treatments
  • Rest from high impact loading
  • Stretching of calf muscles & Fascia
  • Ice with bottle
  • Comfortable cushioning shoes
Clinical Treatments[\captiontitle]

Assessment of lower limb Mechanics

other malalignment issues treated

Strapping

offload & rest plantar fascia

Orthotic/ Insole Therapy

to reduce strain through plantar fascia

Focused stretching regime

to improve function

Injection Therapy

for pain relief

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