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Heel Pain & Plantar Fasciitis

01 Overview

Heel pain can be debilitating and severely affect daily activity. The most common cause of heel pain is Plantar Fasciitis, however, consideration for other causes should always be considered, these include nerve compression, inflammation of the fat pad and even stress fracture.

02 Details

Plantar Fasciitis and heel pain

Pain in the heel can be debilitating and severely affect daily activity. The most common cause of heel pain is plantar fasciitis, however, consideration for other causes should always be considered, these include nerve compression, inflammation of the fat pad and even stress fracture.

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 the 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.

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 into the bases of the toes.

What are the symptoms of plantar fasciitis

Symptoms occur if the fascia becomes injured or inflamed.  Pain is felt at inside of the heel bone (the origin of the fascia)  and/or under the central part of the arch.  Symptoms tend to be a dull ache/throb which is worse following periods of rest such as in the morning when first rising or after sitting.

Gentle exercise may ease things a little as the day progresses.

What are the treatments?

Stretching Regime

Rehab Stretching & Strengthening Regime

A high percentage of patients with heel pain have been shown to have a reduced amount of motion at the ankle due to having tight calf muscles, and weakness in the muscles that control toe function

 

Rest

Rest

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Comfortable footwear

Footwear modification

Comfort is key considering softness and shock absorption, avoiding very flat shoes as these will put more strain on the calf muscles. So a shoe with a small heel or pitch.

Weight loss

Weight loss

Elevated bodyweight has been shown to be a cause of heel pain and plantar fasciitis. This can be difficult as many patients experience heel pain when trying to lose weight by exercising.