The most common cause of heel pain is a condition called plantar fasciitis. Plantar fasciitis is the inflammation of the plantar fascia. The plantar fascia is a broad band of tissue that originates from the heel, runs along the sole of the foot, and connects to the toes.
The plantar fascia works like a rubber band between the heel and the ball of your foot to form the arch of your foot. If the band is short, you’ll have a high arch, and if it’s long, you’ll have a low arch, what some people call flat feet. A pad of fat in your heel covers the plantar fascia to help absorb the shock of walking. Plantar fasciitis is often referred to as a heel spur which is a calcium deposit in the plantar fascia attachment. The heel spur does not cause pain.
Taping
Athletic tape is applied to the plantar fascia and works by reducing tension by preventing the fascia from stretching. The tape is strapped from the heel to the base of the toes. Tension is maintained by the tape thus allowing the fascia to rest and heal. The tape has to stick to the skin for it to work due to the tension being transferred through to the skin. Specific athletic tape should be used. Podiatrists recommend that the tape be applied every morning and removed every evening to allow the skin to breathe.
Shoe Inserts
Shoe inserts are by far the most effective treatment used to manage plantar fasciitis. They help reduce stress at key weight points. Keep each foot properly aligned and cradle, which stabilizes your heels. A strategically placed heel insert made of poron foam absorbs the pounding foot shock of each step.
Rest
Initially, you should decrease any strenuous activities such as sports and long walks to allow inflammation in the fascia to decrease.
Ice and Heat
Proven therapy for plantar fasciitis by alternating application of heat and cold coupled with massage works wonders to relieve pain, reduce swelling, and promote healing. Use an ice pack in the morning and a heat pack in the evening.
Hot/Cold Packs provide therapy that’s constantly in touch with sore muscles, tendons, and tissue. Microwave or freeze the packs depending on the desired treatment cold therapy is especially beneficial in the treatment of plantar fasciitis (heel pain). Apply cold therapy initially and heat therapy when the heel is in the healing phase.
Night Splints
Heel pain night splints maintain the ankle in an upward position and toe extension, creating a constant mild stretch of the plantar fascia that allows it to heal at a functional length.
Speed up the healing process of plantar fasciitis FXT Night Splints with this low profile, thermal lined bootie from Swede-O. The PF FXT allows you to sleep comfortably while gently stretching out the plantar fascia, the band of connective tissue that runs from the heel to the toe. Slip-on the bootie and adjust the dorsal flexion (amount of tension) to pull back the toes towards the ankle.
Stretching
One of the most effective treatment options for plantar fasciitis is stretching. Tightness in the plantar fascia occurs if the Achilles tendon and calf muscles tension increases. Tightening in these muscles increases dorsiflexion (upward movement) of the large toe which stretches the plantar fascia causing it to inflame.
Therefore, it makes sense that reduction of the tightness of the Achilles tendon and calf muscles will have a positive effect on heel pain.
Example Stretch
Plantar fascia-specific stretch. The patient crosses the affected foot over the contralateral leg, grasps the base of the toes, and pulls the toes back towards the shin until a stretch in the arch is felt. The stretch is held for 10 seconds and repeated. Three sets of 10 repetitions are performed daily.
Corticosteroid Injections
Limited evidence supports the use of corticosteroid injections to manage plantar fasciitis. I have known patients that have had corticosteroid injections in the heel by their doctor, and they have reported extreme pain with very little benefit.
Emu Muscle and Joint Gel
This gel, blended with black pepper and Eucalyptus Essential Oil is excellent for relieving muscular aches such as heel pain.
Extracorporeal Shock Wave Therapy (ESWT)
A relatively new treatment option for heel pain is ESWT which involves the usage of high-intensity sound waves to cause neovascularization (tissue repair). ESWT should be used in conjunction with other conservative options such as stretching, orthotics, activity modifications, and maintaining a healthy weight. The success of ESWT is difficult to establish due to different levels of intensity being used by different practitioners. However, anecdotal evidence suggests that this treatment option can be successful, ESWT is not available in all podiatrist surgeries and is generally only available in specialist clinics.
Casting
Casting is rarely a treatment option for heel pain. Podiatrists have applied well-padded fiberglass walking casts with the ankle in a neutral to slight dorsiflexion (upward position). There have been many long-term studies carried out on this treatment option, but the overall casting works similarly to plantar fasciitis night splints.
Surgery
Surgery for plantar fasciitis should be the last option as success rates can be as low as 37% and as high as 60%.
