Heel Pain is a typical nuisance injury that prevents people from enjoying a walk, jog or a round of golf. The most common heel pain that affects the under sole surface of the heel is Plantar Fasciitis. In this article, I will discuss further treatments of Plantar Fasciiitis and other Heal Pain injuries. Plantar Fasciitis could really be called Plantar fasciosis as there is no swelling at the plantar tendon attachment to the calcaneal (heel) bone. Instead there is a thickening of the fibrotic plantar tendon as it attaches to medial calcaneal tubercle of the heel bone. Other conditions that can cause heel pain include irritation of the medial calcaneal nerve that supplies sensation to the heel pad, irritation of the small branch of the lateral nerve of the heel and a boney heel spur.
The Different Symptoms
Heel pain in bed and in sitting suggests nerve entrapment and not plantar fasciitis
Heel pain in the morning time, moving from sitting to standing suggests plantar fasciitis
Heel can described as sore and achy
Constant heel pain would suggest boney heel spur and possibly nerve irritation
Plantar fascia pain can be in the arch of the foot and 3 other points of the heel.
Causes of Plantar Fascia Heel Pain
Foot over-pronates inwards when walking coupled with poor foot mechanics
Sudden increase in a person’s walking or running
Poor or old footwear
Weak gluteal and pelvic muscles causing poor dynamic stability when walking
Nerve testing by the Physical therapist can differentiate if the heel pain is plantar fasciitis or nerve irritation. Manual manipulation of thickening plantar fascia tendon attachment is very beneficial coupled with mobilisation and strengthening exercises to help reduce over-pronation of the foot. If clinical assessment identifies weakness in the gluteal and pelvic area then this needs to be addressed to reduce over pronation of the foot. Nerve sliding and gliding is very beneficial for heel pain caused by local nerve irritation. If heel pain persists that a night splint can wore at night to help reduce morning heel pain. Strengthening exercises for the plantar facia include toe squeezing and eccentric heel raises in the advanced stage of treatment.
Tomás Ryan is a Registered Physical Therapist with The Irish Association of Physical Therapy (MIAPT) and is based in Thurles. Contact Number: 0504 26672. Email; firstname.lastname@example.org
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