Heel Pain, the bane of sportsman and middle aged alike
As summer approaches, podiatrists across Australia will commonly and consistently have one thing in common…heel pain.
Call it whatever you like, plantar heel pain, heel spurs, plantar fasciitis/fasciosis, bruised heel, plantar fasciopathy, there is one thing for sure…IT’S A PAIN! Your podiatrist probably also knows you have read every thread on the internet to banish this curse which the summer has brought upon you.
So what’s the cause of heel pain?
Let’s start with the heel and its structures. Despite the heel bone being quite small, it actually has a large amount of muscular attachments, multiple joint surfaces and undergoes a tonne of stress with every day activity. On the underside of the heel there are numerous ligaments, muscles attachments and a bony prominence called the calcaneal tuberosity. It is found right under the centre of the heel and this is where the action begins.
There many types of causes of heel pain, but commonly there are three main causes of heel pain which a podiatrist would see in a clinic on a daily basis; these are either pain from a heel spur, plantar fasciitis and a nerve entrapment.
The most common cause of heel pain is plantar fasciitis/fasciosis. This is the most likely cause of your pain, but your podiatrist can assess you to identify the other causes. Plantar fasciitis is something we deal with daily and certainly something which most people will experience in their life time. So what is it? This is the, ‘I’m sore first thing in the morning’ pain, and the ‘it’s there when I start walking and goes after a bit,’ type of pain. The plantar fascia is a long ligament which joins to the medial calcaneal tubicle and supports the arch of the foot. During plantar fasciitis there is chronic degeneration of the plantar fascia, this might be due to a number of reasons. Usually, your podiatrist will assess you and ascertain risk factors as to why this horrible ailment is affecting you, but usually if you, stretch your calf muscles, stretch them some more, give a gentle massage to the heel and avoid flat thongs, sandals and barefoot you’ll be alright.
I’ve seen so many people who have tried orthotics, footwear changes, and sexy new treatments like shockwave therapy. I like to treat plantar fasciitis through multiple interventions at the same time. It’s too easy to hand out an orthotic or do some shockwave therapy and forget the basic principles of a treatment plan. As a podiatrist, stretching is usually my first point of call, with a combination of orthotics and footwear changes.
To sum it all up, heel pain doesn’t differentiate between people, flat feet, high arched feet, the fat, athletic or those young in age. Your treatment should have a plan, guided goal and a pain management component. With adequate treatment your plantar fasciitis should resolve. I have only seen a couple of cases where surgery was indicated, but that was after we exhausted every avenue!
Signing off, Mitch 13/11/2017
If you have heel pain, would like a honest assessment and the right treatment give Eltham Foot Clinic on 9431 1138.