Heel pain / Plantar fasciitis

Are you tired of rolling your foot on a golf ball for heel pain? Sometimes, this can provide temporary symptom relief but it may not provide a long-term solution for your problem.

I experienced heel pain for the first time within a couple of months after moving into our new house. In my case, a lot of walking and standing on hard surfaces (wood and tiles) caused it. We had carpet at our old house which was the biggest difference in my routine. I managed my heel pain with physiotherapy treatment, exercises, and a change in footwear.

Heel pain is very common. Many people such as athletes, runners, teachers, and workers experience heel pain. About 1 in 10 people get heel pain at some time in their lifetime. There can be many causes of heel pain. Heel pain can have negative effects on physical and mental health. Plantar fasciitis is one of the most common causes of heel pain and can affect people of all ages and activity levels.

What is plantar fasciitis?

Plantar fascia is a rubber band-like structure that extends from heel to big toe. There can be irritation and inflammation of plantar fascia from various factors such as improper load management, rapid increase in the training frequency or intensity, standing or walking on hard surfaces, improper footwear, and limited hip, knee, or ankle mobility.

What are the symptoms of plantar fasciitis?

1. Dull, stabbing, or burning pain

2. Pain with the first few steps in the morning or weight bearing after prolonged sitting/ inactivity

3. Pain in the bottom of the foot/heel or the arch of the foot

4. Pain increases after exercises or activity

5. Tightness in the calf and Achilles tendon

How is plantar fasciitis diagnosed?

Plantar fasciitis is a clinical diagnosis. Your physiotherapist will run an assessment with a focus on your history of pain, signs and symptoms, gait/ walking analysis, and physical examination to confirm the diagnosis.

Imaging is not necessary. Your physiotherapist may recommend imaging to rule out some conditions such as bursitis if needed.

What is the treatment for plantar fasciitis?

1. Physiotherapy can help to relieve the pain and prevent recurrences.

2. Education: Learn about your cause of pain to manage the pain effectively.

3. Hip, knee, and ankle mobility and strengthening exercises in a progression based on your assessment

4. Manual therapy: Mobilization and manual therapy that may include myofascial release, cupping, and IASTM/ Graston technique.

5. Load management techniques and training strategies for athletic performance

6. Modalities: Acupuncture or Ultrasound to manage inflammation.

7. Taping

8. Footwear modifications

Please be aware that the information stipulated in the article above regarding plantar fasciitis is intended for educational purposes only. If you are experiencing heel pain or suspect that you may have plantar fasciitis, you should consult with an appropriately qualified physiotherapist. Feel free to contact me if you have any questions.

Roopdeep Kaur

Registered Physiotherapist

Roopdeep Kaur, PT, FRCms, MSc. PT, BPT

Reference:

Morrissey D, Cotchett M, Said J'Bari A, Prior T, Griffiths IB, Rathleff MS, Gulle H, Vicenzino B, Barton CJ. Management of plantar heel pain: a best practice guide informed by a systematic review, expert clinical reasoning and patient values. Br J Sports Med. 2021 Oct;55(19):1106-1118. doi: 10.1136/bjsports-2019-101970. Epub 2021 Mar 30. PMID: 33785535; PMCID: PMC8458083.