Heel pain or, plantar fasciitis is the most common cause of foot pain. It affects the thick connective tissue that runs along the bottom of the foot called the plantar fascia.
Although the name implies an inflammation it actually is more of degeneration of the plantar fascia ligament, with very few inflammatory markers evident on analysis.
As with many other tendinopathies ie patella, achilles and elbow, the main cause of plantar fasciitis is often one of over use or unaccustomed use. Whether it be over running, too much walking, too much standing there will be a story of overuse or a story of an unaccustomed activity ie new gym program, new to running. Even in an athletic population, overuse is still likely to be the most common cause ie increase in speed, increase in mileage, change of surface. It is possible to incur a specific acute injury ie trauma, bruising but this is the less common story.
The most common symptoms experienced are;
- Localised heel pain- often to the inside of the heel where the plantar fascia attaches to the heel bone.
- Pain may stretch along the length of sole of the foot
- Often worse in the morning when first taking steps
- Pain when contacting ground at heel strike
The causative factors of Plantar fasciitis can be multi-factorial and the best option is to see a clinician to have your problem fully assessed, so a complete, specific rehab program can be created.
The following can be contributing factors that may need addressing;
- Foot biomechanics– orthotics, strapping techniques.
- Tight Calves– specific calf stretching stretching.
- Lower limb weakness– specific strength program that may include gluteal and pelvic strength work.
- Overload or unaccustomed use– create a specific return to activity program with a graduated loading program to allow for tissue adaptation. Read more about this here.
- Ligament degeneration and soft tissue hypersensitivity– a short course of Shockwave therapy has been shown to be effective.
While a complete assessment and rehab program designed by a health practitioner is recommended, there are number of devices and products that can assist if are suffering from Plantar Fasciitis.
The most common tools are;
- Soft tissue mobilising devices– used to help stretch the calf musculature and also the plantar fascia itself.
- Compression socks– terrific devices to help compress and alleviate the plantar fascia and give relief.
- Strength equipment- there are several products that can help strengthen the small muscles in the foot.
- Unloading devices– these are small devices like heel cups that can unload and soften the immediate contact on the plantar fascia insertion.
- Soft soled/ orthotic footwear- especially if you have hard floors at home these can help reduce the the impact on the fascia.
There are solutions if suffering from plantar fasciitis and it will improve and get better. The key is to have a very pragmatic and logical approach and to ensure you have a graduated return to activity. It is recommended that you seek help from a health professional that can create a complete, specific program for you.
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