Plantar fasciitis is one of the most common conditions seen by Podiatrists. It presents as pain on the bottom of the heel. Pain on the bottom of the heel can be caused by a multitude of reasons and getting a diagnosis is an important part of the process! The most common reason for pain on the bottom of the heel is plantar fasciitis, a painful condition that affects a strong band of tissue running from the heel to the toes.
What is the plantar fascia?
The plantar fascia is a complex band of tissue that serves many roles including slowing down arch collapse during gait and absorbing shock. The plantar fascia becomes painful when the load placed on the plantar fascia becomes too high for the tissue to recover from. This can be caused by direct force from impact or when the plantar fascia is under stretching force (or both!).
What causes plantar fasciitis?
The Plantar fascia experiences impact force with every step when the heel hits the floor and experiences stretching force with each step throughout the day. The stretching or tension force running through the plantar fascia can be made worse if muscles that affect the plantar fascia are restricted in range of motion or weak. One key example of this is the calf muscle, when the calf muscle is tight there is an increased risk of plantar fasciitis due to the pulling force from the calf on the heel and into the plantar fascia.
What are the symptoms of plantar fasciitis?
The pain is most common underneath the heel. It is usually worsened on your first step after rest and is often described as a dull ache during exercise. Pain is individual and the experience can differ from person to person, your pain may sound just like this or feel like something else entirely.
X-ray's and Ultrasounds are not usually needed for the diagnosis of plantar fasciitis in patients with heel pain, however sometimes they may help guide the clinical treatment path or be used to rule out other potential sources of pain in the foot.
What are the treatment options for plantar fasciitis?
There are a range of non-surgical treatment plans for plantar heel pain. The treatment plan should be focused on decreasing the load/ force on the tissue. Ways of decreasing the load on the tissue can include: custom orthoses, sports taping, footwear changes and braces. These will be prescribed when needed and will be based around a full and thorough biomechanical assessment which will look at any abnormalities which may be causing the pain in your heel. This assessment will include watching your lower limb positioning during your walking cycle to see what your foot does in motion as well as checking the strength and mobility of your joints to check your risk factors and help prevent re-occurrence.
Once the load is managed effectively, some cases of heel pain, particularly in chronic cases, may not resolve as quickly as anticipated. In these cases, treatments that stimulate healing may be warranted. Treatments that TFC Podiatry recommend to some patients during their treatment path that fall into this category include: dry needling, massage, injections or medications.
This information is of a general nature, if you have pain. A definitive diagnosis from a health care professional and treatment plan based on your own case is very important.