Heel Pain (Plantar Fasciitis)

On both feet, you have a tissue called the plantar fascia that starts at the bottom of your heels, and fans out across your arch to connect to the toes. This fascia helps maintain the shape of your arch and the bones, joints and muscles that comprise it. Any time you take a step, the fascia is placed under some tension, but this is usually a healthy amount that it is designed to handle. When this tissue gets damaged, often from higher than normal loads, your heel pain starts. This is called plantar fasciitis.

The damage to your plantar fascia will have occurred either from direct trauma to the heel bone, like jumping down from a height, or from increasing the load on the fascia. This may occur through:

• Suddenly increasing your physical activity duration or intensity
• Changes in your lower limb movement and function (biomechanics)
• Being more vulnerable due to your foot posture, e.g. flat feet
• Wearing unsupportive footwear
• Increased body weight, as well as increased training weights at the gym

A telltale sign of plantar fasciitis is heel pain when you get out of bed first thing in the morning, and when you stand up after resting. This pain is often severe, but can be mild, depending on the extent of the damage. The pain tends to ease as you continue to walk, and for many settles within the first ten minutes, if not the first ten steps. As the injury worsens, you’ll feel more pain more often, until it persists throughout the whole day. Swelling may also be experienced.

If plantar fasciitis is left untreated, it may progress to a partial tear of the fascia, or even a full rupture.

We help hundreds of patients every year with their plantar fasciitis heel pain. More than just relieving the pain and helping the fascia to heal, we address all the contributing factors, from foot function to footwear, to reduce the likelihood of the pain coming back in the future. We ensure that you are equipped with the tools and knowledge to help you make the best decisions to look after your feet, long after your treatment with us.

• Fat pad atrophy describes the thinning or breakdown of the fatty pads at the bottom of your feet. As these pads work to help us absorb shock from walking, force from heavy loads, and protect our bones and joints, their damage can result in pain at the heels.
• Tarsal tunnel syndrome describes the compression of a nerve that passes down the leg and across the inside of the ankle, below that bony bump (malleolus), and down beneath the arch. It gets its name because the compression occurs in a tunnel between the tarsal bones. This entrapment can produce a variety of symptoms across the foot, one of which can be heel pain.