Plantar Fasciitis: Healing Your Heel Pain

It is estimated that roughly 10% of the population will have heel pain at some point in their life and is the most common foot issue seen by clinicians. The plantar fascia is a thick band of tissue that runs from the heel bone, calcaneous, to the first bone of the toes, the proximal phalanx. It has been discussed that the term fascia may be incorrect and the term aponeurosis best describes the structure. An aponeurosis is flat band of tissue that behaves more like a tendon. The plantar fascia supports the arch of the foot and consists of three bands of tissue: the lateral, medial, and central portion. The central band is what extends from the heel to the toes.

Plantar Faciitis Signs and Symptoms:

  • Point tenderness to the medial aspect of the heel
  • Pain along the arch
  • Pain in the morning with the first few steps
  • Pain with activities such as running, walking, or prolonged standing
  • Pain as your take your first few steps after after being stationary for a longer period of time

Possible Causes:

  • Altered foot mechanics secondary to stiffness and/or weakness of the lower extremity and hip
  • Decreased ankle range of motion, particularly into dorsiflexion (flexing the foot upwards)
  • Elevated BMI
  • Prolonged standing and weight bearing activities throughout the day

Things to try:

  • Stretching the plantar fascia and calf complex several times a day
  • Specific taping techniques to the foot and arch for short term relief
  • Short term use of orthotics
  • Manual physical therapy to mobilize stiffness in the ankle/foot complex and other tissues
  • Strengthening for specific weakness of the ankle/foot complex as noted during examination
  • Progressive return to activities with graded exposure
  • Specific exercises to hips, core, and lower extremities as indicated based upon examination findings

Every individual and every episode of plantar heel pain is very unique. The treatment suggestions listed above include several options to try and see how they may improve your situation. In addition, a thorough evaluation by a physical therapist can help identify specific features about your condition and how to best manage them. Your plan of care is going to be specific to where you are in the recovery process and the extent of the injury. Progression of movements is quality based. As you demonstrate greater competency and capacity to do the movements they need to be progressively more challenging. Understanding as much as possible about your current condition is a very important aspect of the recovery process and will empower you to take the necessary steps to get back to your normal activities with as little discomfort as possible.

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