Heel pain

Pain felt in the heel can have a number of different causes. The most common cause is ‘Plantar Fasciitis’. This has sometimes been described as an overuse condition of the plantar fascia (the band of tissue that forms the arch of your foot, extending from the ball of the foot to the heel). You may hear people call this condition ‘heel spurs’, and even though they may have spurs on X-ray, the spurs are not usually the cause of their pain.

It may also be called Plantar Fasciopathy as it is likened to a Tendinopathy. Our Physios are skilled in the load management & treatment of Tendinopathies. You can read more here.

Other Causes of Heel Pain

Even though plantar fasciitis is the most common cause of heel pain, there are other causes. Another common cause is Fat pad syndrome (‘bruised heel’ or ‘stone bruise’), and this is usually caused by a fall onto the heels from a height, or excessive heel strike when walking/running. Other causes may include back pain referral, Achilles tendinopathy, stress fractures and nerve entrapment.

Symptoms

Often heel pain can be persistent, but commonly is worse in the morning, getting slightly better through the day only to become painful again at night. This relates to weight bearing periods, loading & tissue repair. Pain is located on the bottom of the heel, usually towards the inside.

Contributing Factors

• Poor ankle range of movement/tight calves
• Foot posture, motion and function (eg very flat footed – overpronation, arch collapse or very high arched – supinated rigid foot)
• Prolonged standing
• Training changes
• Age, height and weight
• Foot injury
• Adiposity. There is a link between plantar fasciitis & increased girth
• Changes in physical activity; either increased or decreased load with inactivity
• Poor / inappropriate footwear

Treatment

Both Physiotherapists and Podiatrists can help to treat this condition. A Physiotherapist can give you advice on what changes you need to make to your activities, strengthening exercises of the feet & lower limb, help treat any calf and plantar fascia tightness or ankle and foot joint stiffness, use strapping tape to provide some relief, and give you some exercises to manage the problem and footwear advice. A Podiatrist can also assist, especially in long-term heel pain that is related to your foot position and movement, by prescribing orthotics.

So, if you’re experiencing heel pain, don’t just ignore it in the hope it will go away, get it checked out by a Physiotherapist. Make an appointment now.

Heel Pain needs to be assessed & managed early as it rarely resolves on its own.