Plantar heel pain

What is Plantar Heel Pain?

This is by far the most common condition affecting the foot; one in ten people develop it at some time in their life. It is most common in people between the ages of 40 and 60 years; however, it can occur at any age. Women are twice more likely to develop this condition than men. It is also common in athletes. The good news is that with appropriate advice and treatment this will resolve for the vast majority of people.

Treatment protocols for heel pain almost always start with basic principles and we would encourage you to consider trying some self-help treatment before making a referral to your local Podiatry department.

What is the Plantar Fascia?

The plantar fascia is a strong fibrous band that stretches from the heel to your toes. It is made up of three bands that run along the inside, middle and outside of the bottom of your foot. The inside and outside bands support the arch and act as shock-absorbers.

Shock absorption is important as it reduces the impact your body weight has on the foot when walking, running and carrying out any weight-bearing exercises. Not only does the plantar fascia support the arch, but it also stabilizes the foot to allow you to push off through your toes.

When pain develops in the plantar fascia, it can be very disabling. Every step can become more painful and cause you to change the way that you walk. When this happens it can lead to strains to other parts of your body.

Plantar Fasciopathy used to be called plantar fasciitis, this is the most common condition affecting the foot. The condition is usually diagnosed by clinical findings alone.

What are the signs and symptoms of Plantar Heel Pain?

You may experience any or all the following:

• A gradual onset of pain affecting the base of the heel
• Pain in the heel during the first steps when you get out of bed in the morning
• Pain in the heel when weight bearing after a period of inactivity or rest
• Pain that eases or lessens with moderate activity
• Worsening pain later during the day or after long periods of standing or walking

What causes plantar heel pain? 

In most cases, plantar heel pain develops because of changes to the way our foot functions with small tears occurring within the plantar fascia. These injuries happen at a rate faster than the body can heal them and as a result the plantar fascia starts to become thickened and painful. The pain is most felt under the inside of the heel but can be anywhere along the bands of the plantar fascia.

You may have contributing factors related to plantar heel pain:

• Being overweight
• Weakness in the muscles within your feet or leg
• Tightness in the muscles up the backs of your legs
• Wearing unsupportive footwear such as shoes or sandals which have a low heel and do not support the feet
• Spending long periods standing or walking, especially with a sudden increase in these activities
• Jobs that involve standing or walking on hard surfaces for long periods of time
• Sudden increase in physical activity levels- for example, recently started running

What can help with plantar heel pain?

Unfortunately, there is no quick or easy fix, and your symptoms will not improve overnight. Plantar heel pain is self-limiting and, in many cases, will improve without any treatment. It is important though that if you have any of the contributing factors you make the necessary changes to help your recovery.

Making changes to your lifestyle as well as reducing aggravating activities is key to helping your recovery. 

There are a few things you can try including:

• Rest and raise your foot on a stool when you can
• Put an ice pack (or bag of frozen peas) in a towel on the painful area for up to 20 minutes every 2 to 3 hours
• Wear shoes with cushioned heels and good arch support
• Use insoles or heel pads in your footwear
• Try regular stretching and foot exercises
• Try exercises which put no pressure on your feet, such as swimming
• Try to lose weight if you are overweight or obese

These a few things to try to avoid including:

• Avoid walking or standing for long periods
• Avoid wearing high heels and tight pointy shoes
• Avoid wearing flip-flops or backless slippers
• Avoid walking barefoot on hard surfaces