Heel pain

What is heel pain?

Plantar fasciitis (or more correctly known as plantar fasciopathy or plantar heel pain) is a complex condition with many associated factors. The plantar fascia is a connective tissue that supports the structure of the foot by connecting the heel bone with the metatarsal bones in the forefoot. This links the heel bone (calcaneum) to the toes. Pain is associated with an overload and irritation of the plantar fascia.

What are symptoms of heel pain?

Plantar fasciitis is characterized by pain under the heel. Pain is often worse first thing in the morning (first step pain) or after prolonged rest. It usually settles down with activity as the area warms up. It can affect one or both feet at the same time.

What causes plantar fasciitis?

Majority of associated factors of plantar fasciitis are related to increased force being transmitted by the plantar fascia. Changes to training load, starting a new physical activity, change in general load and inappropriate footwear are some of the causes. A higher body mass index increases the risk of plantar fasciopathy due to excessive load on the plantar fascia and increased fat cells in the blood and connective tissue. There is mixed evidence to suggest that pronation (rolling in of the foot) during weight bearing can increase the associated risk.

How can I treat plantar fasciitis?

After your plantar heel pain is diagnosed there are a variety of treatments your Podiatrist will be able to choose from. It is a persistent condition that gets more difficult with time to manage. These will be based on an individual assessment due to activities, lifestyle, foot type and pain levels.

Treatments for plantar fasciitis include:

  • Load management
    The podiatrist will identify the overloading factor, which could be activity or work related. The aim will be to modify or may temporarily decrease it to allow enough rest for healing. Our aim is not for complete rest as this doesn’t lead to a reduction in symptoms.
  • Offloading – taping
    Taping of the foot for plantar heel pain is to offload the foot and temporarily decrease the pain. There are a number of different techniques available depending on the foot type and tolerance.
  • Correctly fitted shoes
  • Exercises/Strength
    A specific foot and leg strength program is needed to help improve the load tolerance of the foot and plantar fascia. There needs to be enough load and challenge for the body to adapt and to be effective. The Podiatrist will make this specific to your ability and areas of weakness.
  • Shockwave therapy (ESWT/ Extracorporeal Shockwave Therapy)
    Used in conjunction with other treatments, shockwave therapy helps promote increased blood flow to the plantar fascia to enable healing. You can read more about shockwave here.
  • Orthotics
    To offload the plantar fascia an orthotic can be used to provide extra support and help decrease the pain. There are generic orthotic devices and custom-made orthotics depending on your foot type and severity. This can be a temporary solution to reduce the pain, and will always be conducted with adjunct treatments and strengthening exercises. 
  • Cortisone injections
    A cortisone injection may be used to break the inflammatory cycle of plantar fasciopathy and would be conducted under ultrasound guidance. This is usually a late-stage treatment when conservatives aren’t reducing pain.

Some other treatments which you can do at home include:

  • Rolling your foot on a ball
  • Changing the surface you train on 
  • Completing your strengthening exercises provided by your podiatrist

If you need help with plantar fasciitis or have any concerns the team at Momentum Podiatry Group in Parkdale are experts at treating heel pain. 

Book online or call 9587 2855.

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