Heel Pain

You might be excited to start a regimen of a daily run, bike ride, or walk. But then, over the first few weeks, you develop pain on the bottom of your heel. When motivation has finally gotten you off the couch and into your workout shoes, this small area at the bottom of your foot is now keeping you from reaching your fitness goals.

This pain on the bottom of your foot could be related to plantar fasciopathy (commonly referred to as plantar fasciitis). You may have heard of this condition before but do not know the details of how it develops or how it can be treated.

What is the plantar fascia?

Also called the plantar aponeurosis. This fascia helps to maintain the longitudinal arches of the foot. It consists of 3 bands that run from the front of the bone at the heel (calcaneus) to the bones that sit just before the toes (metatarsal heads).¹ The fascia tense when the toes lift up and relax when the toes curl down.¹ This process helps the foot conform to different surfaces.¹ It provides shock absorption when the foot is flat and creates a stiffer surface to push off of when the toes are extended.

What is Plantar Fascitis/Fasciopathy?

The exact cause is still up for debate, but many theorize the condition is an overuse syndrome of the plantar fascia caused by repetitive loading, such as with a recent increase in running or walking distances, intensity, or frequency.²

Those who have an increased risk of developing this condition include:³

• People with decreased motion when lifting the foot upwards
• Jobs that require standing on hard surfaces for long periods of time
• Running, especially on hard surfaces and/or with recent increase in running intensity and duration^3,4
• Increased body mass in those who are not athletic

Common symptoms include:³

• Pain in the inner heel after the first step or after inactivity
• Pain in the inner heel that worsens with prolonged activity

How do is Plantar Fascitis treated?

There is a widespread belief that this condition will resolve on its own, but treatment has been shown to decrease the severity and help people return to their daily activities faster than just taking a wait-and-see approach.⁵ Why wait to see how long it takes to go away, if at all when you could come to physical therapy and stop this issue once and for all?

What will your physical therapy sessions look like?

Your Physical Therapist will help reduce pain and improve your function using a combination of manual therapy techniques in conjunction with exercise. We will use various stretches to improve how your ankle and foot move and taping to provide short-term relief of symptoms.¹ We will also take the time to educate and discuss the best ways to increase exercise intensity and duration so that your body can adapt to where you need to be to achieve your goals.

Disclaimer: Several conditions can cause heel pain other than plantar fasciitis. Other causes of this pain may not benefit from the advice shown above. However, you could still benefit from physical therapy to determine the cause and how to resolve your symptoms.

References:

1. Neumann, D. A. (2016). Kinesiology of the musculoskeletal system (3rd ed.). Mosby.
2. Plantar Fasciitis. Rehabilitation Reference Center (RRC). March 2020. Accessed May 23, 2021. http://search.ebscohost.com/login.aspx?direct=true&db=rrc&AN=2009544221&site=eds-live
3. Martin RL, Davenport TE, Reischl SF, McPoil TG, Matheson JW, Wukich DK, McDonough CM; American Physical Therapy Association. Heel pain-plantar fasciitis: revision 2014. J Orthop Sports Phys Ther. 2014 Nov;44(11):A1-33. doi: 10.2519/jospt.2014.0303. PMID: 25361863.
4. Di Caprio F, Buda R, Mosca M, Calabrò A, Giannini S. Foot and lower limb diseases in runners: assessment of risk factors. J Sports Sci Med. 2010;9:587-596.
5. Plantar Fasciitis: Will Physical Therapy Help My Foot Pain? J Orthop Sports Phys Ther. 2017 Feb;47(2):56. doi: 10.2519/jospt.2017.0501. PMID: 28142369.