Heel pain is one of the most common conditions treated by podiatrists and can affect children as well as adults. It is important to note that is can be caused by various conditions such as heel spurs, plantar fasciitis, plantar fascitsis and nerve entrapment just to name a few.Successful management of this condition involves a multifaceted approach. At Health plus Chiropractic, we believe that involving all aspects of treatment in order to produce the best possible outcome.
The three main areas which need to be addressed are:
Soft tissue – treatment may include stretching and strapping.
Foot mobilisationBiomechanics – A full biomechanical assessment is carried out and orthotic management prescribed to correct any abnormal issues which may be contributing to the condition
Footwear – This is a major part of the treatment plan. Often inappropriate footwear can lead to heel pain and in many cases prevent it from getting better.
Your podiatrist will need to perform a biomechanical assessment which includes joint range of motion testing, muscle function testing and gait analysis to determine the cause of the symptoms, It is sometimes necessary to get medical imaging such as x-rays or ultrasound to aid in diagnosing the condition.
One of the more common conditions that cause heel pain is plantar fasciitis. Typical symptoms include pain during the first steps in the morning and after period of no-weight bearing which then tends to subside. As the condition becomes more chronic, the pain can be present throughout the day.
Your podiatrist will be able to properly advise you regarding footwear. Once the cause of the heel pain is determined, your podiatrist will be able to devise a customised treatment program addressing soft tissue, biomechanics and footwear.
Treatment varies according to the severity of the condition and may include orthotics, soft tissue management (stretching, strengthening, trigger point therapy, dry needling, massage) and footwear advice.
Podiatry & Foot Pain
In most cases, heel and arch pain are caused by overpronation of the foot and foot subluxations. Overpronation is a rolling in of the foot. A dropped for fallen arch is now an overpronated foot. This overpronation of the foot eventually leads to an inflammation of the fascia, muscles, and ligaments on the bottom of the foot. This condition is diagnosed as plantar fasciitis and if the patient continues to exercise, the inflammation worsens and can lead to calcaneal bursitis. Prolonged inflammation of the plantar fasciitis will eventually lead to a calcaneal traction spur.
Calcaneal bursitis is usually extremely painful on rising in the morning. Many patients state that they can barely hobble around for the first 30 minutes of the morning but as the day progresses, pain diminishes. This is due to the change in the bursal sac, which becomes engorged with fluid while the patient is sleeping. This enlarged sac is very painful to put pressure on upon rising. As the body is in a weight bearing position during the day, the fluid is pushed out of the sac only to return again when the body is at rest in the evening. Eliminating running or aerobic activity may lead to a reduced pain level, but in most cases, the injury will reoccur if the biomechanical problem of overpronation is not corrected.