Heel Pain? Plantar Fasciitis Might be the Culprit!
Have you ever stepped out of bed in the morning only to be greeted by excruciating heel pain as if stepping on glass? Does the same thing happen when you’ve been on your feet for a while or when you stand up from your desk? It could be plantar fasciitis and you’re not alone.
Plantar heel pain worldwide is estimated to cost $1 BILLION a year affecting 1 out of 10 people over a lifetime (YES – $1 BILLION… WOW!).
If we look at the anatomy of the foot, the plantar fascia connects the heel bone to the 5 toes and several muscles and tendons travel through the ankle and foot. The plantar fascia and muscles all function to support the arches of our feet. This creates a very effective shock absorber as well as a rigid structure for us to propel ourselves with as we walk. Once the fascia, muscles, or tendons become irritated we end up with heel pain.
Some of the factors associated with heel pain include:
- Alignment problems – Overpronation of the foot, high arches, or limited mobility of the 1st
- Anatomical factors – Tight calf muscles or tight ankles.
- Training errors – Increasing running intensity and volume too quickly (it’s very common in runners!).
- Improper footwear – Worn out or poorly fitting shoes.
- Obesity – Increased vertical force on the heel.
In scientific literature, the term “plantar fasciitis” has gradually replaced by the term “plantar heel pain” for a couple reasons. First, the suffix “itis” refers to inflammation and is inaccurate as biopsy studies on patients with chronic heel pain have shown the plantar fascia pain is due to a degenerative process without inflammation. Secondly, considering the presence of other structures in the area, one cannot always assume it’s the plantar fascia at fault.
Luckily, there are several treatment options for plantar heel pain including:
- Functional exercises
- Manual therapy
- Extracorporeal shockwave therapy
- Acupuncture and dry needling
- Rehab products such as custom or over-the-counter orthotics, soft silicone heel cups, or night splints
If you’re having heel pain at home, here are a few of our favourite exercises to get you started!
Plantar Fascia Stretch and Self Massage
- Sit with your injured foot placed across your opposite knee.
- Holding your toes, pull your ankle and toes up and gently massage the arch of your foot.
- Perform the stretch and massage for 1 minute.
Standing Calf Stretch
- Stand and place hands on a wall, with your feet about 24” away from the wall.
- Place the injured foot behind the other and lean your body forward without bending the back knee until you feel a stretch in your calf.
- Keep both feet pointing straight forward.
- Hold the stretch for 20-30 seconds and repeat 3 times.
Calf and Arch Strengthening
- Stand on a step with a small rolled up towel under your toes and heels hanging over the edge.
- Lift yourself up onto your toes as high as you can.
- Slowly lower heels until you feel a stretch in your calves.
- The movement should be 3 seconds up, 2-second hold, 3 seconds down, and 2 seconds stretch.
- Repeat 2 sets of 10 repetitions.
Remember – No 2 cases of plantar heel pain are necessarily the exact same. What works for 1 person does not always work for the next. That’s why it’s always important to have an in-depth assessment by a qualified physiotherapist or chiropractor in order to find out what treatment approach is best for you.
If you have nagging heel pain and want to feel better, give Peach Physiotherapy in Chatham-Kent, Ontario a call at 519-358-7342 to set up a 60-minute 1-on-1 assessment to find out how we can help!
Lemont HI, Ammirati KM, Usen N. Plantar fasciitis: a degenerative process (fasciosis) without inflammation. J Am Podiatr Med Assoc. 2003 May-June;93(3):234-7.
Tong KBI, Furia J. Economic burder of plantar fasciitis treatment in the United States. Am J Orthop (Belle Mead NJ). 2010 May;39(5):227-31.