Plantar Fasciitis and Heel Spur Pain

What is plantar fasciitis and heel spur pain?

It is a condition that causes pain in the heel and bottom of the foot. It occurs when the thick band of tissue that connects the heel bone to the toes (plantar fascia) becomes inflamed or irritated. Excessive tension on the heel bone can also cause a bony growth to develop (heel spur)

What causes it?

  • Loss of ankle dorsiflexion mobility
  • Stiff big toe
  • High arched foot or excessive foot pronation
  • Impact/weight-bearing activities such as prolonged standing, running, etc.
  • Improper shoe fit, worn-out shoes or footwear with poor arch support
  • Training on hard surfaces
  • Obesity/ weight gain
  • Tight calf muscles
  • Weakness of the shin and intrinsic foot muscles

What symptoms might you experience?

  • Heel pain with first steps in the morning or after long periods of non-weight bearing
  • During weight bearing activity, pain and stiffness will be noticed initially but would become less or disappear after a few steps only to recur later
  • Pain is usually worse when barefoot on hard surfaces and with stair climbing
  • Pain improves with rest from loading/ high impact activities

How is it treated?

As with most musculoskeletal conditions, management must involve a combination of medical and physiotherapeutic treatments.

Medical management involves prescription drugs to relieve pain, inflammation and ease muscle spasm e.g. NSAIDs and muscle relaxants; topical pain relief e.g. analgesic patch; joint injection if recommended. Imaging may be ordered to rule out heel spurs

Physiotherapy management

  • Load management (e.g. heel cup/ orthotics to improve load distribution) & resting from high impact activities
  • Footwear recommendation
  • Ice massage
  • Therapeutic modalities such as SIS therapy and ultrasound treatment
  • Manual therapy as tolerated (therapist applies hands-on treatment to alleviate stiff joints and tight muscles where applicable)
  • Therapeutic exercises to help restore pain-free movement and address muscle imbalances
  • Gait retraining (optimize running/walking pattern)
  • Dynamic/ proprioceptive taping (to improve foot posture & alleviate pain)

Lifestyle management

  • Improve diet & weight control

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