Why do I have heel pain?

Suffering from heel or arch pain? Is it worse when you take your first steps in the morning?

You could be suffering from plantar fasciitis - an injury to the strong sling (plantar) connective tissue that lies under the medial arch of the foot.  

What are the symptoms of plantar fasciitis?

Focal heel pain stretching along the medial arch is the most common symptom of plantar fasciitis. Pain is usually worst first thing in the morning and will ease as the foot gets warmed up with activity. As the condition becomes more severe the pain can often become worse throughout the day, especially with weight-bearing activities.

What caused my foot and heel pain?

The plantar fascia acts like a spring, supporting the medial arch and supplying energy to your feet.  As the fascia thickens it loses its flexibility and strength. The collagen fibres are then prone to degeneration which results in pain.

The resulting irritation of the fascia, typically where it connects to the heel bone, creates a painful inflammatory response that is sometimes accompanied by tearing of the tissue structure.

Once inflamed, the plantar fascia is easily stressed and aggravated. Standing on hard surfaces in bare feet or after a night’s sleep can easily stress and aggravate an inflamed plantar fascia.

The most common causes of plantar fasciitis:

• Tightness of lower limbs including calves, hamstrings and gluteal muscles
• Unsupportive footwear
• Weight gain
• Occupations that involve stair/ladder use
• Increases in exercise
• Overtraining and overuse
• Incorrect technique

Having high arches can also impact on the foot’s ability to absorb shock.

Further reading: What are flat feet?

How do you treat plantar fasciitis?

Treatment for this condition includes:

• Footwear assessment
• Gait analysis
• ROM studies
• Stretching and strengthening
• Advice on pain relief
• Shockwave therapy
• Orthotics

Soft tissue massage and myofascial release of the muscles of the lower limb can also give great pain relief and promote correct biomechanics

The key to treating plantar fasciitis is to remove the load on the arches of your feet. This is achieved through rest and modification including orthotics, taping and correct footwear.

In the early stages of treatment, pain management is critical including stretching, ice, and some form of soft-tissue therapy.

It’s also critical to strengthen not only the arch of the foot but also the other load dispersing structures of the lower limbs such as your calves and hips.

A quick and effective way to treat plantar fasciitis is Shockwave therapy. This works by sending acoustic waves to the troublesome area which causes a healing response involving tissue repair and cell growth. Normally after one treatment you can already feel the benefits.

Further reading: How to treat Achilles tendon pain and plantar fasciitis

Determining the cause of your heel pain

Not only do we work at treating the symptoms at Back In Motion but we feel it is important to find out what caused the problem in the first place so we can ensure your injury doesn’t reoccur.

Plantar fasciitis is much easier to treat as an acute condition and can be difficult to treat when you have progressed into a chronic phase. If you feel you may have this problem, seek professional treatment immediately rather than letting it linger and hoping it will ‘just fix itself’.

Putting up with the pain can also lead to further injuries, particularly if you change the way you walk to compensate. People often find they walk on the outside border of the heel – the can lead to further and future biomechanical issues.

Think you might be impacted by plantar fasciitis? Contact your local Back In Motion practice to book your free initial assessment.

Author

Thanks to Carl Bedard, podiatrist at Back In Motion Bribie Island for his contribution to this week's blog. Carl was born in raise in Canada and had extensive experience in private practice in the UK before relocating to Queensland to join the team at Bribie Island. Whether it is for foot health advice, a persistent ingrown toenail or you're just struggling to reach your feet and need general footcare, Carl is available to do a thorough treatment.