Ouch!!! I Have Heel Pain! Is It Plantar Fasciitis?
By Dr Gordon Lazarte
What is Plantar Fasciitis?
The Plantar fascia is a thick band of tissue that inserts at the base of the heel bone and attaches at the base of the big toe joint. It is the arch that you see in the middle of your foot. The plantar fascia plays a key role in helping our feet push off from the ground and acts as a natural shock absorber.
Plantar fasciitis can be inflammation of your arch, but more commonly it is a degenerative tendon injury (meaning it has progressively stressed or overused over a long period of time). This overstretching and micro-tearing of the plantar fascia causes sharp irritable pain that is felt at the heel and arches.
What Causes Plantar Fasciitis?
Plantar Fasciitis can develop due to a lot of factors, some of which being:
- Sudden increase in activity
- Poor flexibility at the ankle joint
- Flat feet or high arches
- Poor biomechanics of the foot and body
- Arthritic conditions
- Autoimmune diseases
- Weight gain
- Occupations that require long periods of standing
- Poor fitting footwear
What Are The Symptoms Of Plantar Fasciitis?
Symptoms of Plantar Fasciitis will vary between people; however the common symptoms include the following.
- Sharp pain usually felt under the heel and arch area
- Usually most intense after periods of rest, the first steps when getting out of bed or after a long period of sitting down.
- Heel pain after exercise, but usually not during.
- Mild swelling at the heel
How Is Plantar Fasciitis Diagnosed?
Plantar fasciitis can be diagnosed based on patient history and clinical symptoms. Our specialist podiatrists will perform a Biomechanical Assessment (testing the movements and strength of the joints and muscles), and then highlight the key factors which may be contributing to the heel pain as well as rule out any other conditions. Generally, there may be pain when palpating certain areas on the underside of the heel and arch.
Imaging such as ultrasound and X-ray can also be used to confirm Plantar Fasciitis and to rule out other conditions. It is also common for a heel spurs to be present along with Plantar Fasciitis.
What Is The Treatment For Plantar Fasciitis?
Treatment of Plantar fasciitis involves reduction and elimination of pain and restoring normal foot and leg biomechanics. Care should be taken when looking for shoes as patients should avoid open back shoes, “flat” shoes with no raised heel and shoes that are too soft.
To reduce the amount of pain that occurs with the first steps after a period of rest, it is important to “warm up” the plantar fascia with some simple exercises which can be shown by your podiatrist.
Treatment Plans For Plantar Fasciitis Can Include:
- Rest or reduction or modification in activity
- Change of footwear if current shoes are ill fitting.
- Strengthening exercise regime of the calf and lower leg muscles
- Stretching regime to increase flexibility at the ankle Joint
- Orthotic therapy which will help in the redistribution of pressures and taking load off the plantar fascia
- Dry needling therapy which will release tight bands of muscle and relieve muscle tension
****NOTE: It is important to note that heel and arch pain if left on its own will not go away. Not all heel and arch pain is plantar fasciitis, other diagnoses for heel pain can mean very different treatment to the above thus assessment and diagnosis from a podiatrist is essential. ****
If you or a loved one suffers from heel pain and would like to be assessed please phone us on (03) 9372-7452 or use our online booking form today to make an appointment today.
Article by: Dr Gordon Lazarte BHSc MPod MAPodA