plantar heel pain syndrome
Heel pain affects ±1/10 people.
The Plantar Fascia is a broad, fan shaped fibrous structure that starts at the heel bone, runs the length of the foot and ends at the ball of the foot. It maintains the integrity and shape of the arch. It is important for forward propulsion and therefore very important during walking. Due to this, it is subjected to high amounts of stress.
Pain is typically located at a particular spot under the heel, and is worse during the first steps taken in the morning, or after periods of rest.
Often there are no signs of inflammation in the area and therefore cannot always be diagnosed as Plantar Fasci-ITIS. Plantar Heel Pain Syndrome (PHPS) is a more appropriate umbrella term that incorporates other problems, as well as inflammatory Plantar Fasciitis.
It is not necessarily that the plantar fascia is pulling away from the heel bone. The fat pad below the heel bones may also be compromised, resulting in poor shock attenuation, traumatising the attachment of the plantar fascia in compression rather than tension.
It may be necessary to have an X-ray and/or Ultrasound scan of your foot.
Risk Factors for Heel Pain
Local / systemic disease
Diabetes
Rheumatoid Arthritis
Ankylosing Spondylitis
Systemic Lupus Erythematosus
Tuberculosis
Structural abnormalities
Flat feet
High arched feet
Leg length difference
Heel bone spur
Activities & Sports
Running
Cycling
Dancing
Crossfit/Hyrox
Court Sports (padel, tennis, netball)
Lifestyle
Increased body weight
Weight bearing occupations
Footwear – worn, inappropriate
Training surfaces
Other
Older (50+ yrs)
Weakness in leg muscles
Reduced flexibility
Treatment Option for Heel Pain
Physical
Ice Bottle Rolling
Massage
Plantar fascia stretching
Calves & hamstrings stretching
Strengthening
Weight Loss
Dry Needling
External
Strapping
Splinting
Footwear
Orthotic device
Other
Cortisone Injections
Platelet Rich Plasma Injection
Extracorporeal Shockwave Therapy
Medical professionals that may be involved
Podiatrist
Physiotherapist
Biokineticist
Chiropractor
Sports Physician
Surgeon