In this information guide we want to provide some useful tips for those of you who may be experiencing some heel pain. More specifically, we will focus on a common cause of heel pain, Plantar Fasciitis.
There are several causes of heel pain. For most people, foot problems can come and go without any prescribed treatment, or can respond well to self-treatment. One of the most common foot problems we see as physiotherapists is plantar fasciitis. In fact it accounts for about 10-15% of all foot related pain in people participating in sport and exercise. It is a problem that several Fit to Tackle members have previously come to see us about and will hence be the focus of this guide.
How do I know I have plantar fasciitis?
There are some signs that can suggest the pain you are experiencing in your heel might be due to plantar fasciitis. Pain should be felt at the point on your heel where the plantar fascia attaches.
So, if you find yourself shouting ‘ouch’ or something a little more ‘colourful’ when you first step out of bed and find yourself walking on your tip toes to the bathroom, then you may have plantar fasciitis!
Although the image here shows someone performing the stretch on another person, it can be easily down yourself by pulling the big toe towards you.
What is Plantar fasciitis?
There are several explanations for what causes plantar fasciitis and researchers continue to try and understand the condition better. Some feel that it is caused by inflammation at the site where fascia attaches under your heel bone, while others suggest that the process is similar to that of a tendinopathy.
When you should see a Healthcare Professional
It is important to remember that there are many other reasons why you may experience pain in the heel and foot. If you have a known condition such as rheumatoid arthritis, scleroderma or diabetes, you should discuss any new foot problem with your Rheumatologist, GP, Chartered Physiotherapist or a Podiatrist.
Even if you don’t have any significant health conditions, you should still seek help if your foot problem:
- involves ulceration of the skin or is infected
- impairs the blood flow to the skin
- has caused pain for more than three months
- is getting noticeably worse
- is changing the colour of your skin – especially if it’s dark blue or black
- is leading to progressive changes in the shape of your foot.
You should also seek help if you develop foot problems and you have increased swelling, if you’re on drugs which suppress your immune system (including steroids or biologics), or if you have a history of poor skin healing.
What to do if you think you have plantar fasciitis
Our advice differs slightly depending on the irritability of the symptoms and how long you have been experiencing the pain. If the pain has only recently started then we suggest following the PRICE guidance.
If you’re part of an exercise programme, such as Fit to Tackle, remember to speak to one of the instructors and explain that you are experiencing heel pain. They should be able to modify some of the exercises to reduce the stress and allow things to settle and hopefully avoid you having to stop the programme.
Soft gel heel cups can be really useful to ease the pain. You can buy these from most chemists, online or through our physiotherapy clinic.
If you are interested in purchasing these through Physiostation, please don’t hesitate to get in touch via email, phone or through our social media pages.
In physiotherapy, we can offer a variety of treatments that have been shown to be helpful for plantar fasciitis.
Treatments include manual therapy, consisting of joint and soft tissue mobilization, to treat relevant lower extremity joint mobility and calf flexibility deficits and to decrease pain and improve function.
If the taping technique is successful we may then recommend that you purchase some foot orthotics (insoles) to help control pronation of the foot and support the medial arch.
For some people, a change in footwear may be all that is needed. Trainers that are designed to provide additional arch support and that have good cushioning are often recommended.
Podiatrists are specialists in foot problems and it can very helpful to seek their advice regarding footwear and insoles if your foot pain is persistent. We work closely with The Bridge podiatry clinic and would recommend their services.
If your heel pain is less irritable but had been ongoing for longer than 3 months we usually recommend strengthening exercises and movement training for muscles that control foot motion and absorb the forces that are transmitted for the foot.
As with all problems involving muscles and tendons, heel pain can last variable lengths of time. For most people symptoms will settle with time, simple stretches and some modification of your activity. It is not unusual to have some symptoms for up to 12 months, although with the right management the symptoms are usually minimal and for may will settle far sooner than this.
If you have any questions about your heel pain, please do not hesitate to get in touch with us at Physiostation.