Home / Heel Pain & Plantar Fasciitis

The plantar fascia is a strong band of tissue that maintains the integrity of the arch of the foot, acts as a shock absorber and aids in the toe-off phase of the walking cycle.
The plantar fascia originates from the inside of the heel bone/calcaneum, spans the arch and attaches to the bases of the toes.
Symptoms
Symptoms occur if the fascia becomes injured or inflamed.  Pain is often felt at the origin of the fascia on the inside of the heel and under the central part of the arch.  Symptoms tend to be a dull ache/throb which is worse in the morning on first rising or after sitting for a period of rest.  Gentle exercise may ease things a little as the day progresses.
Common causes of heel pain:
TRAUMA/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 INTENSITY OF SPORT OR ACTIVITY
A sudden increase in intensity in sporting activity or non-sport related activity can place an increased amount of pressure through the fascia.
INCREASED BODY MASS INDEX/ OVERWEIGHT
Research reports up to 80% of patients who present in the clinic are overweight, carry increased weight puts more strain through the feet, weight loss plays an important role.
FOOTWEAR
Flat, unsupportive footwear, i.e., prolonged use of flip-flops in the summer
Abnormal biomechanics – excessive foot pronation or rolling in  Inflammatory arthritis
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 often enough to provide a very accurate diagnosis, sometimes 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

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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