Heel pain is one of the most common presenting complaints at our clinic. It can range from mild to severe in its nature, and if left untreated can lead to serious complications. People often describe symptoms including morning pain, shooting pain, swelling and pain with activity. Heel pain can be caused by a number of conditions, including plantar fasciitis, Achilles tendinitis, heel spurs, fractures of the calcaneum, posterior tibial tendon dysfunction and nerve entrapments.
Plantar fasciitis is the most common cause of heel pain. Typically there will be pain upon standing after a period of rest, especially first thing in the morning, as well as at the end of the day. As the condition worsens, pain may be present all day long. The condition itself is the inflammation of the plantar fascia – the fibrous band that runs under the foot. Most cases of plantar fasciitis occur at the insertion of the plantar fascia into the heel bone, and is often caused by excessive pronation of the foot. Aggravating factors include inadequate footwear, a recent increase in activity and weight gain.
Plantar fasciitis can often be mistaken for other causes of heel pain, however our experienced and qualified podiatrists are able to perform a thorough assessment and make an accurate diagnosis. Treatment consists of stretching, padding and strapping, rest from aggravating activities, footwear modification and orthotics. We will be able to recommend the appropriate treatment for each individual case of plantar fasciitis. If required, our podiatrists are able to fit you with a customised orthotic which will correct the alignment of the foot and allow healing to occur.
Achilles tendinitis is the inflammation of the Achilles tendon – the tendon that connects the calf muscles to the heel bone. It is caused by excessive strain on the Achilles tendon which creates micro tears. Precipitating factors include inadequate footwear, sudden increase in activity, weight gain, tight calf muscles and excessive pronation of the foot. The typical presentation of Achilles Tendinitis is pain and swelling at the back of the heel which is exacerbated by activity.
A multifaceted treatment approach is required for Achilles tendinitis and includes stretching and strengthening, heel raises, footwear modification, rest from aggravating activities and orthotics to correct any biomechanical causes.
Heel spurs often occur in conjunction with plantar fasciitis. Essentially, it is a bony formation at the insertion of the plantar fascia into the heel bone. It is caused by the same mechanism that leads to plantar fasciitis. Heel spurs can typically be quite painful during formation, however this pain often subsides. In most cases, it is the inflammation of the plantar fascia itself and not the heel spur that causes pain.
Treatment consists of the same approach taken for plantar fasciitis; stretching, padding and strapping, rest from aggravating activities, footwear modification and orthotics.