Heel Pain - Plantar fascia injury and treatment

Plantar fasciosis or plantar fasciopathy is a common injury in runners and walkers. It is often referred to as plantar fasciitis. This condition causes heel pain on the under side (plantar surface) of the foot. Most patients will describe an ache or bruised feeling under the heel with weight bearing activites. It is common for the pain to quite bad first thing in the morning as the sufferer gets out of bed and takes their first few steps. 

Plantar fasciopathy is caused by a mechanical overload of the plantar fascia. The plantar fascia is an inelastic connective tissue which runs from under the heel all the way to the toes. The overload of this connective tissue usually occurs as a result of a combination of an increase in the amount of walking or running plus a problem with the biomechanics. 

Treatment of plantar fasciopathy involves: initially off-loading the painful tissue with the use of tape or an orthotic device to allow the pain to settle; correcting the biomechanical issues which have lead to the injury in the first place; strengthening the tissue through specific exercises; a gradual return to the activities which overloaded the plantar fascia such as running or walking. This method of treating plantar heel pain is usually quite effective. Usually this injury can be managed without having to stop running or walking entirely.

There are other conditions which can cause pain under the heel which are less common and can occur in isolation or in combination with plantar fasciopathy. These include: nerve entrapment of the medial or lateral plantar nerves; fat pad contusion; referred pain from the lumbar spine. 

If you are suffering from heel pain you should seek an accurate diagnosis and treatment plan from one of our Sports Physiotherapists or Podiatrists. 

Sam Bugeja - Sports Physiotherapist

Plantar fascia