Heel pain is something we commonly treat at Physiologix. Plantar Fasciitis and foot tendinopathy are frequent causes of the pain, but there are many other reasons for heel pain.
Plantar fasciitis is irritation of a strip of thickened tissue that runs from the forefoot to the underneath of the heel. It comes very tight when you raise onto your toes, for example, when you push off to walk. An increase in sudden load, such as walking or running further, faster, or whilst carrying more weight can cause a flare up. Over stretching might also be an issue, for example if you are crouched down doing something for a while. Pain is typically felt in the middle of the under-surface of the heel and can be very painful when weight is placed through the heel, or when raising up onto the toes.
Just to the inside of the under-surface of the heel, more under the arch of the foot, there are several tendons that may become painful: the FHL, flexor digitorum and tibialis posterior – foot tendinopathy can be found in any of these tendons with a similar cause as with the plantar fasciitis, but where there is usually a bit more pressure through the inside of the foot; this might be found with someone that flattens their arch or roles their foot in when they weight bear over the foot.
Also in the arch are some small nerves that can become irritated, the pain often being more of a burning type pain.
Achilles Tendinopathy is pain over the back of the heel. There is a fat pad and a bursa that may also become irritated in this area as well.
And then there are other causes of heel pain; circulation and nerve damage can be involved with things like diabetes. Other systemic inflammatory conditions can occur. And rarely a fracture can exist under the heel bone.
The heel is a small and complex area to treat. Our physios will teach you what to do….and what not to do. They will suggest basic off the shelf orthotics and discuss shoe wear where indicated. They will help you strengthen your feet, teaching you to work the small deep muscles of the foot, the foot intrinsics, as well as the bigger muscles around the foot and ankle. How you move, your biomechanics will be assessed and addressed where needed. And exercises for up the kinetic chain, for example, around the hip and pelvis may also be required.
Suffering with heel pain or know someone who is? Please give us a call any time on (07) 3511 1112 to discuss.