Heel Pain Part 1 – Plantar Fasciitis

Recently a client asked me “is having heel pain first thing in the morning, just one of those things you have to put up with as you get older”?.

What are the causes of Heel Pain?

There are two major causes of heel pain, firstly a grumbling Achilles Tendon and secondly Plantar Fasciitis.  This week I am going to focus on Plantar Fasciitis.  Plantar Fasciitis is inflammation of the Plantar Fascia or the strong band of tissue on the sole of your foot that stretches from your heel to your toes that supports the arch of your foot and acts as a shock absorber when you walk.  The usual site of the pain with Plantar Fasciitis  is on the sole of the foot, see diagram below.

Cross-section diagram of the foot showing the plantar fascia

How can I tell if my heel pain is Plantar Fasciitis?

Plantar Fasciitis is characterised by the gradual onset of soreness and aching under the heel at its mid-point, which spreads forward along the inner side of the arch of the foot.   The ache or pain is often for the first few steps when you get out of bed every morning or after sitting at your desk for a long period of time.

What causes Plantar Fasciitis

  • Sedentary Lifestyles
  • Being overweight
  • Wearing shoes with too little arch support or cushioning
  • Vigorous take off’s, landings are fast turns during weight bearing sports.
  • Wearing high heels too much.
  • Excessive foot eversion (your weight is too much on the outside of your foot).

What can I do to help myself?

If you are in pain, then simply rest and ice.  A simple solution is to freeze a plastic water bottle which is about 75% full of water – when it is frozen wrap it in a tea towel, so you don’t burn your skin and roll it under the sole of your feet to provide pain relief.

The following exercises, done either with or without shoes on, can be used to help treat Plantar Fasciitis:

  • Stand about 40 cm away from a wall and put both hands on the wall at shoulder height, feet slightly apart, with one foot in front of the other. Bend your front knee but keep your back knee straight and lean in towards the wall to stretch. You should feel your calf muscle tighten. Keep this position for several seconds, then relax. Do this about 10 times then switch to the other leg. Now repeat the same exercise for both legs but this time, bring your back foot forward slightly so that your back knee is also slightly bent. Lean against the wall as before, keep the position, relax and then repeat 10 times before switching to the other leg. Repeat this routine twice a day.
  • Stand on the bottom step of some stairs with your legs slightly apart and with your heels just off the end of the step. Hold the stair rails for support. Lower your heels, keeping your knees straight. Again you should feel the stretch in your calves. Keep the position for 20-60 seconds, then relax. Repeat six times. Try to do this exercise twice a day.
  • Sit on the floor with your legs out in front of you. Loop a towel around the ball of one of your feet. With your knee straight, pull your toes towards your nose. Hold the position for 30 seconds and repeat three times. Repeat the same exercise for the other foot. Try to do this once a day.
  • Sit on a chair with your knees bent at right angles and your feet and heels flat on the floor. Lift your foot upwards, keeping your heel on the floor. Hold the position for a few seconds and then relax. Repeat about 10 times. Try to do this exercise five to six times a day.
  • For this exercise you need an object such as a rolling pin or a drinks can. Whilst sitting in a chair, put the object under the arch of your foot. Roll the arch of your foot over the object in different directions. Perform this exercise for a few minutes for each foot at least twice a day. This exercise is best done without shoes on.

Finally, a deep tissue massage to the calf muscles, achilles tendon and foot will help too.

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