Heel pain in adults is one of the most commonly presenting complaints to our podiatrists, with the most common cause being plantar fasciitis. The plantar fascia is a ligament that connects the heel to the ball of the foot. Under normal circumstances, your plantar fascia acts like a shock-absorbing bowstring, supporting the arch in your foot however if tension becomes too high, damage may occur. It can affect one or both heels and usually occurs without a history of trauma.
Pain is usually felt on the underside of the heel, and can present as a stabbing pain. Pain is often most intense with the first steps of the day or after rest. Once your foot limbers up, the pain of plantar fasciitis normally decreases, but it may return after long periods of standing or after getting up from a seated position.
Factors that may increase the risk of developing plantar fasciitis can include:
Age: common between the ages of 40 to 60
Certain types of exercise: those that place a lot of stress on your heel (e.g. dancing and running)
Poor foot mechanics: being flat footed, having a high arch or even an abnormal walking pattern can place extra strain on the plantar fascia
Weight: overweight individuals have extra pressures going through the fascia
Occupation: those that have you standing or walking around for long periods
Initial treatment often includes gentle stretching of the Achilles tendon and plantar fascia, weight loss, taping for arch support and the possible prescription of heel lifts. Care should also be taken by the patient to wear supportive and stable shoes; open-back shoes, sandals, thongs, and flat shoes should be avoided.
Long term treatment can include the use of orthotics, night splints, exercise and stretching regimes. For more persistent cases cortisone injections or surgery may advised.