Plantar Heel Pain (known as Plantar Fasciitis)
- Is your heel or arch pain worst after periods of rest or with your first step in the morning?
- Does your heel or arch pain increase with the amount of time you’re on your feet?
- Does your heel pain have a ‘burning, tingling or numbness’ quality to it?
- Do you have pain in your heel(s) at night when you are not on your feet?
- Does your pain worsen throughout the day?
Are the above symptoms affecting or stopping what you love to do?
If your answer is “yes” to one or more of the above questions, then you are not alone. It is recommended that you see one of our specialist sports podiatrists as early as possible to avoid the condition from deteriorating.
Heel pain is reportedly the most common foot complaint anywhere in the world, and plantar fasciitis is the most frequent cause of it. Typically, people experience sharp pain and tightness when getting out of bed in the morning and after prolonged sitting, bruising or aching pain on weight-bearing during the day, and is generally worse towards the end of the day or after exercise.
What is Plantar Heel Pain (PHP)?
Plantar fascia is a band of connective tissue that runs along the bottom of the foot from heel to toes. It helps to support movement and integrity of the arch of your foot.
Although plantar fasciitis and plantar fascosis (inflammation and deterioration of the plantar fascia) are known to be the typical diagnosis of plantar heel pain, there can be up to 20 other differential diagnosis including; calcaneal apophysitis (growing pain in children), Baxter’s nerve entrapment, trigger point referred pain conditions, gout and even rheumatoid arthritis. We cautiously diagnose your heel pain with thorough clinical assessment and sometimes medical imaging, to ensure we develop the most effective treatment plan to get you back doing what you love to do as fast as possible.
Why do I get heel pain?
Commonly people think they developed heel pain “all of a sudden.” However, long-standing of poor biomechanics (structure and movement of your foot and leg) is usually the key factor to developing the problem. When the joints of your foot and ankle are not functioning in their correct position, the supporting soft tissues such as muscles and tendons would get stressed from trying to compensate, this includes the plantar fascia under your foot. When the plantar fascia gets overloaded continuously, it would eventually lead to pain, tears, inflammation, and deterioration including the formation of a heel spur.
The truth about heel spur is this; you can have a short history of heel pain, but had an asymptomatic heel spur for many years.
The attachment of the plantar fascia on the heel bone becomes calcified when it gets chronically strained. This happens when the mechanical pressure on the plantar fascia creates a traction force that causes it to get pulled away from the heel bone. The calcification is the heel spur that we would normally see on an x-ray. While the spur may look concerning, it does not cause the pain like most people would have thought. The fact is that a heel spur can be present for many years without pain, however, researchers have found that most people with chronic heel pain would have a heel spur. The tension, tightness, impact, and inflammation of the plantar fascia are usually what cause the pain associated with a heel spur, rather than the spur itself causes pain.
What do we do about it?
People would generally experience some degree of relief with conventional treatments such as wearing an orthotic device, ultrasound, strapping, stretching, and foot exercises. Yet, we often see people experience little relief or recurring symptoms with the above treatments when the true issue of pain has not been addressed.
At Footwork Podiatry, our sports podiatrists are specialized in correcting the mechanical misalignment of the foot and ankle and addressing the exact tissues that are under stress with our advanced manual therapies. A systematic review by (Fraser et al., 2012) has concluded that manual therapy is clearly associated with improved function and pain reduction in plantar fasciitis patients, particularly when combined with rehabilitation exercises.
One of the important treatment modalities that we have mastered for resolving chronic heel pain is treating the whole fascial chain starting from the plantar fascia up to the calf and hamstrings with our myofascial release techniques such as western medical acupuncture and instrument-assisted soft tissue mobilisation , since any dysfunctions along the posterior chain can cause pain under the arch or heel.
To maximize pain reduction in the shortest time possible, we may employ Shockwave Therapy as an adjunct therapy to breaks down scar tissue and promote the body’s healing response. It is a proven, evidence-based treatment for chronic heel pain. Discover more HERE .
If traditional treatment methods have not worked for you, chances are one of the heel experts at Footwork Podiatry can create a significant difference for you! We are the expert in lower limb pain and injury treatment and are committed to providing holistic health care to make a difference for our patients.
CALL US to discuss how we can help you feel better TODAY!
Fraser, J.J., Corbett, R., Donner, C., Hertel, J. 2017 Journal of Manual and Manipulative Therapy. pp. 1-11
Effective solutions for heel pain, heel spurs, arch pain, plantar fasciitis, plantar fasciosis:
- Foot Mobilisation Techniques
- Trigenics® Functional Muscle Neurology
- Shockwave Therapy
- Western Medical Acupuncture
- Movement Assessment Technologies
- Low Level Laser Therapy
- Instrument Assisted Soft Tissue Mobilisation
- Active Release Techniques
- InterX Neurostimulation Therapy
- Custom Foot Orthoses
- Kinesiology Sports Taping
- Corrective / Rehabilitation Exercise