Ever found yourself limping as you get out of bed in the morning? You are not the only one. Foot pain affects one in five Australians and heel pain in particular is one of the most common presentations seen by health professionals each week. Early signs of heel pain are often ignored due to our busy lifestyles and our sometimes dismissive attitudes towards our foot health.
Heel pain is often associated with inefficient loading of the foot during weight bearing activity such as walking or running. It is normally the first part of the body to make ground contact as we take each step. Heel pain is often attributed to minor faults in our individual makeup of musculoskeletal structures and the way we use these structures to move and function day in, day out. Our choice of footwear, the ground surfaces we walk upon, the varying nature of sport or physical activity, underlying systemic disease and excessive body weight will also all have a significant impact on the capacity of our feet to absorb force with each step.
The vast majority of heel pain is caused by plantar fasciitis. Plantar fasciitis is inflammation of the Plantar Fascia – a broad band of fibrous tissue which runs along the bottom of the foot from the heel to the forefoot. It acts as a key stabilizing feature which enables the foot to remain a solid structure when propelling body weight forward with each step. Inefficient loading of the foot can cause altered stretch on the fascia which often will result in inflammation and pain at the attachment to the bottom surface of the heel. It often presents as pain first thing in the morning or immediately upon weight bearing activity following rest periods. Often in the initial stages of heel pain presentation, the pain will slowly improve with walking and then repeat the pain cycle after any periods at rest. It is not uncommon to experience these symptoms as a result of poor choices in footwear or when we have increased our usual weight bearing activity level in a rapid fashion. Prime examples of this being starting a higher intensity gym program or drastically increasing the distance of a run.
It is crucial to seek professional advice early upon the start of heel pain symptoms. Not only do the symptoms need to be treated, but the underlying cause needs to be properly identified. Heel pain may have a neurologic, traumatic or systemic underlying cause. It is not uncommon for the diagnosis of plantar fasciitis to be given without thorough examination ruling out other causes such as localized nerve entrapments, proximal nerve entrapments, intrinsic muscular strains within the foot, Achilles tendonitis, heel spurs and inflammatory arthritis.
Through thorough assessment and correct diagnosis by your Podiatrist, treatment can be directed to address the underlying cause of your heel pain. Conservative treatments often include mechanical support, tissue specific stretching and exercise, activity modification and footwear advice and/or modification. Whatever your individual circumstances, with correct diagnosis, our aim is get your heel pain under control and get you back to the activities you enjoy.