Heel pain and what to do about it

Plantar fasciitis is the most common cause of heel pain. It is an irritation or inflammation of the plantar fascia — the ligament that runs from the heel to the ball of the foot. This is a strong, dense strip of tissue that supports the arch of the foot, almost like the string on an archer’s bow.

When the foot is on the ground, the plantar fascia is forced to stretch as the arch of the foot is flattened under weight of the body; like the string stretching as the bow is trying to straighten.

This leads to stress on the plantar fascia ligament, where it attaches to the heel bone. Some small tears of the fascia may result. These tears are usually repaired by the body, but repetitive stress may result in incomplete healing. A bone spur can form as the body tries to compensate for too much stress.

Pain in the heel can occur due to such bone spurs, inflammation of the plantar fascia (known as plantar fasciitis) or impingement of the small nerves in the foot. The condition is most common between the ages of 40 and 60.

Symptoms of plantar fasciitis include pain on or around the heel when weight is placed on the foot. This is usually worse in the morning, especially with the first few steps out of bed and can be described as sharp, burning or stabbing pain. Pain usually reduces during the course of the day as the tissue warms up. In most cases, there is no pain at night since the plantar fascia is not stressed. Prolonged standing, walking or getting up after long periods of sitting usually irritate the fascia.

Common causes

  • Overload of physical activity, excessive running or jumping
  • High arches, flat feet, abnormal gait
  • Wearing improper shoes while walking or running
  • Recent weight gain or pregnancy
  • Occupations that keep you on your feet
  • Diabetes contributes to heel pain in the elderly
  • Right steps to relief

    In most cases, plantar fasciitis does not require surgery and can be treated conservatively. If you suffer from heel pain, make an appointment with your physiotherapist. Ignoring plantar fasciitis may result in chronic heel pain that hinders your regular activities. Simply changing the way you walk to avoid pain could lead to other foot, knee, hip or back problems.

    Therapy usually involves identifying the cause of your foot pain and a series of treatments. You may be prescribed specific footwear and exercises. Physical Therapists will design exercises to improve flexibility in the calf muscles and the plantar fascia. Treatment helps control pain and swelling. We may use ultrasound, mild electrical stimulation, ice packs and soft-tissue massage to help you recover as fast as possible. We may even recommend the use of orthotics depending on your condition. Keeping mobility and flexibility in the foot is key to improve quality of life.

    Call our practice today, and we’ll help you take the right steps without pain!


    How to get the most from your physiotherapy appointments


    An appointment with a physiotherapist is an excellent step towards improved function and injury prevention. To make the best use of your time, please use the following guidelines:

    Wear comfortable clothes. Jeans or long sleeves are not advisable during your initial evaluation since the therapist may need to evaluate your joint stability. You may be asked to take off some clothes and put on a gown to give your therapist access to the body areas needing evaluating.

    Make sure to arrive a few minutes prior to your appointment in case you need to fill out some forms.

    Elaborate on the things you are unable to do, or the level of function you would like to achieve with your physiotherapist. This will help the therapist to serve you as effectively as possible.

    Provide information about when the pain started, the nature of pain (sharp or dull), what caused it, and what aggravates it.

    Remember that you and your physiotherapist are part of a team with a common goal – to get you better as quickly as possible. Do your home exercise program exactly as instructed and try not to miss any appointments in an effort to reach that goal.


    Quick tip

    Using your hands, gently pull the toes back and forth or apart. This stretches the muscles underneath.

    Inspiration

    Enter every activity without giving mental recognition to the possibility of defeat. Concentrate on your strengths instead of your weaknesses, on your powers instead of your problems.

    ~ Paul J. Meyer

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