Heel pain is most commonly caused by plantar fasciitis, which is the swelling of the tissue that connects the heel bone to the toes at the bottom part of the foot, also known as the plantar fascia.
Plantar fasciitis is often described as sharp pain in the middle of the heel, which is typically worse after periods of rest when fascia contracts. The pain usually becomes more bearable as the
muscles loosen up during the low-impact walking, but can return even worse after extended periods of walking or standing. The plantar fascia serves as a shock absorber and supports the footâs arch.
Too much tension on the plantar fascia can cause inflammation and swelling. Fortunately in most cases, plantar fasciitis treatment is fairly conservative. Plantar fasciitis exercises, medications and
orthotics are usually all thatâs needed to manage the pain. Most severe cases may require surgery.
Plantar fasciitis is caused by drastic or sudden increases in mileage, poor foot structure, and inappropriate running shoes, which can overload the plantar fascia, the connective tissue that runs
from the heel to the base of the toes. The plantar fascia may look like a series of fat rubber bands, but it's made of collagen, a rigid protein that's not very stretchy. The stress of overuse,
overpronation, or overused shoes can rip tiny tears in it, causing pain and inflammation, a.k.a. plantar fasciitis.
The major complaint of those with plantar fasciitis is pain and stiffness in the bottom of the heel. This develops gradually over time. It usually affects just one foot, but can affect both feet.
Some people describe the pain as dull, while others experience a sharp pain, and some feel a burning or ache on the bottom of the foot extending outward from the heel. The pain is usually worse in
the morning when you take your first steps out of bed, or if youâve been sitting or lying down for a while. Climbing stairs can be very difficult due to the heel stiffness. After prolonged
activity, the pain can flare-up due to increased inflammation. Pain is not usually felt during the activity, but rather just after stopping.
Plantar fasciitis is usually diagnosed by your physiotherapist or sports doctor based on your symptoms, history and clinical examination. After confirming your plantar fasciitis they will investigate
WHY you are likely to be predisposed to plantar fasciitis and develop a treatment plan to decrease your chance of future bouts. X-rays may show calcification within the plantar fascia or at its
insertion into the calcaneus, which is known as a calcaneal or heel spur. Ultrasound scans and MRI are used to identify any plantar fasciitis tears, inflammation or calcification. Pathology tests
(including screening for HLA B27 antigen) may identify spondyloarthritis, which can cause symptoms similar to plantar fasciitis.
Non Surgical Treatment
Treatments you can do at home include rest. Try to avoid activities that put stress on your feet. This can be hard, especially if your job involves being on your feet for hours at a time, but giving
your feet as much rest as possible is the first step in reducing the pain of plantar fasciitis. Use ice or a cold compress to reduce pain and inflammation. Do this three or four times a day for about
20 minutes at a time until the pain goes away. Take anti-inflammatory medications. Painkillers such as ibuprofen or acetaminophen can help relieve pain and reduce inflammation in the affected area.
Your doctor may also prescribe a medication called a corticosteroid to help treat severe pain. Exercise your feet and calves. When the pain is gone, do calf and foot stretches and leg exercises to
make your legs as strong and flexible as possible. This can help you avoid getting plantar fasciitis again. Ask your coach, athletic trainer, or a physical therapist to show you some leg exercises.
Rolling a tennis ball under your foot can massage the area and help the injury heal. Talk to your doctor about shoe inserts or night splints. Shoe inserts can give your feet added support to aid in
the healing process. Night splints keep your calf muscles gently flexed, helping to keep your plantar fascia from tightening up overnight. Have a trainer or sports injury professional show you how to
tape your foot. A proper taping job allows your plantar fascia to get more rest. You should tape your foot each time you exercise until the pain is completely gone. For people who get repeated sports
injuries, it can help to see a sports medicine specialist. These experts are trained in evaluating things like an athlete's running style, jumping stance, or other key moves. They can teach you how
to make the most of your body's strengths and compensate for any weaknesses. Once you're healed, look for the silver lining in your bench time. You may find that what you learn from having an injury
leads you to play a better game than ever before.
Surgery is not a common treatment for this condition. Approximately 5% of people with plantar fasciitis require surgery if non-surgical methods do not help to relieve pain within a year. The surgical
procedure involves making an incision in the plantar fascia in order to decrease the tension of the ligament. Potential risks of this surgical procedure include irritation of the nerves around the
heel, continued plantar fasciitis, heel or foot pain, infection, flattening of the arch, problems relating to the anesthetic.