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Plantar Fasciitis (Heel Pain)

What it Effects

  • A fibrous sheath (Plantar Fascia) on the sole of the foot running from the heel to the base of the toes

Who it Effects

  • Older population
  • People who do a lot of standing / walking
  • Sports people
  • Women

Mechanism of Injury

  • There is inflammation caused by micro trauma of the Plantar Fascia where the sheath attaches to the heel, usually resulting from overuse
  • Obesity
  • Biomechanical problem
  • A tight Achilles tendon has been shown to contribute to this condition
  • Inadequate footwear can contribute

Signs and Symptoms

  • Pain on the heel and down the inside of the foot
  • Point tenderness
  • Pain when the Plantar Fascia is put on stretch
  • Sharp pain on the heel especially in the morning and during activity
  • Pain is less when non-weight bearing

Treatment

  • PRICE
  • NSAID’s
  • Fix biomechanical problem e.g. over pronation
  • Stretching the Plantar Fascia and Achilles
  • Deep transverse frictions
  • Ultrasound

Additional Information

  • At a recent in-service training in the NHS it was recommended by Jim Barrie an ankle and foot surgeon that physiotherapists should screen patients for the following to rule out inflammatory conditions as a cause of heel pain:
    • Problems with other joints
    • Ulcers in the mouth
    • Red hot eyes
    • Blood / discharge in the urine
    • Psoriasis
    • Lower back pain

If you have any questions, please use the comment form below or post a thread on the forums.

— Phil @ 9:07 pm, July 19, 2006


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