You may have heard of plantar fasciitis – whether it be that you have it, had it before or someone you know has it.
In recent times due to changes in the literature and scientific advances, plantar fasciitis has been renamed to a broader term called ‘Plantar Heel Pain’, although the term is still used interchangeably.
What is Plantar Fasciitis/Plantar Heel Pain?
Plantar heel pain refers to pain felt underneath the heel or foot.
The pain usually a stabbing/sharp type of pain and is felt especially when taking your first few steps in the morning, running or walking.
It can also be felt if you are standing for long periods or when you get up from sitting.
Plantar heel pain is generally felt where the plantar fascia (which is a thick fibrous structure) inserts into the heel bone (see image below).
Often, pain is felt right underneath the heel, although it can extend along the bottom of the foot towards the toes.
What Causes Plantar Fasciitis/Plantar Heel Pain?
Plantar heel pain can arise for a number of reasons.
The anatomical reasons for this can include (but are not limited to);
- A bone spur on the calcaneum (heel bone)
- Inflammation or tissue changes of the plantar fascia
- Inflammation or thickening of the calcaneal fat pad
- Atrophy (shrinking) of the calcaneal fat pad
- Chronic thickening of the plantar fascia
Other factors are considered to be lifestyle or contributing factors for plantar heel pain.
These include (but are not limited to)
- Altered foot biomechanics (high or low arch, foot rolling inwards)
- A sudden increase in exercise (particularly running, walking, jumping)
- Recently beginning to exercise after a long period of time off
- Standing for long periods of time without rest
- Standing on a different (harder) surface than what you are used to
- Being overweight
- Walking for a prolonged time bare foot
How Can Physiotherapy Help Plantar Fasciitis/Plantar Heel Pain?
You may think that because it is pain that is in your foot that you need to see a podiatrist, but you DON’T!
Physio’s treat plantar heel pain ALL the time, and we LOVE it!
What we CAN do to treat it includes;
- Assess and treat altered foot and lower leg biomechanics
- Dry needling
- Exercises to help you gradually build up load to the plantar fascia
- Exercises to help you stretch surrounding structures that can be contributing to tightness in the foot (eg stretching your calves)
- Ultrasound for pain relief
- Fit off the shelf orthotics to reduce pressure going through your heel
- Exercises to build strength to the musclses in the foot and ankle for good biomechanics
Some though, can be super stubborn and that is when we may refer you to a podiatrist who may recommend specialist orthotics or inserts for your shoes.
7 Tips To Help Your Plantar Heel Pain At Home
It is important to get help for your plantar heel pain as early as possible.
In addition to seeing your physiotherapist, here are some of our favourite things that we prescribe in treatment sessions!
- If it is very painful – freeze a drink bottle of water and roll under the arch of your foot.
- Use a golf ball/spikey ball to roll underneath the foot to loosen the structures that are tight.
- Wear supportive footwear – especially ones with a good arch support and that aren’t too firm on the sole.
- Toe curls – using a tissue under the sole of your foot, try and use your toes to scrunch the tissue (1minute)
- Foam rolling your calves (1 minute each calf)
- Calf strengthening exercises (eg. calf raises – raise up and down on your toes x20)
- Calf stretching – gastrocs and soleus. (Hold 30-45 seconds)
Calf Stretch (front knee bent, back knee straight)
Soleus Stretch (both knees bent)
***This is general advice and you will require proper guidance from your physiotherapist to ensure that these exercises are appropriate for you as well as correct technique.
Plantar Fasciitis/Plantar Heel Pain Takes Time
An important thing to remember is that plantar heel pain takes TIME to heal (don’t mind the pun!).
It is important to initially reduce your pain, then you must increase the load to the plantar fascia over time for it to adapt to change and ultimately be pain free!
Consult your physiotherapist if you are experiencing any pain as EARLY as possible!
The sooner you get onto it, the sooner it will recover!