Plantar Heel Pain

What is it ?

Commonly known as plantar fasciitis / plantar fasciopathy. Plantar fasciitis is inflammation of the plantar fascia, a thick and fibrous band of tissue on the sole of the foot connecting the heel to the toes. It provides shock absorption and stability to the foot to maintain normal motion when walking, and plays an important role in supporting the arch of your foot.

Plantar fasciitis is classified as an overuse injury, indicating that the tissue undergoes stress and excessive stretching, leading to micro-tears. The body then heals these tears by forming scar tissue, which is less elastic than regular tissue, making the plantar fascia susceptible to repetitive tearing. This sets off a continuous cycle of tearing, inflammation, scarring, and thickening of the plantar fascia, ultimately resulting in irritation and pain.

Failure to address this cycle can result in the gradual deterioration of the condition over time.

Causes

• New or increased activity

• Repetitive high impact activity (running/dancing/sports)

• Prolonged standing on hard surfaces (especially among nurses, factory workers, and teachers)

• Foot posture/biomechanics of feet (flat feet or a high arch)

• Tight calf muscles

• Obesity

Signs and Symptoms

• Stabbing or aching pain in the inner heel or sole of the foot

• Worse with first steps in the morning, or when standing after sitting for a long period of time.

• Sometimes eases with walking, however pain can worsen after a long day standing or walking

Treatment

• Over the counter anti-inflammatory medications to provide immediate relief

• Physical therapy including low-level laser therapy, myofascial release or dry needling

• Activity modification

• Exercise therapy: including strengthening exercises for the feet, and stretching of calf muscles.

• Footwear modification and orthotic therapy

• Strapping