Plantar Heel Pain

Contributing Factors associated with Plantar Heel Pain

INTRINSIC FACTORS

– Body weight

– Biomechanics

– Foot intrinsic muscle mass and strength

– Foot posture

EXTRINSIC FACTORS

– Training errors

– Footwear 

– Work load (i.e., time on feet)

Considerations in the management of Plantar Heel Pain

SHORT TERM

• Assess to determine possible tissue source

Not all heel pain is the result of irritation of plantar fascia tissue. Assessment of your presentation is necessary to try and determine the source of your symptoms.

• Load modification

Load often needs to be modified to reduce symptoms and allow contributing factors to be assessed and addressed. This doesn’t mean no running, but running load should be reduced to a volume that provides an opportunity for tissues involved to rest and recover. 

• Dry Needling & Soft Tissue Techniques

These techniques can help to improve the health of affected tissues.

• Calf (and plantar fascia) stretching

Stretching of calf and plantar tissues can be effective in the management of symptoms.

• Taping

Taping applied to the bottom of your foot can be effective in the short term management of symptoms. It can offload affected tissues, allowing them the opportunity to rest and recover.

• Footwear considerations

Footwear is often an important consideration in the management of plantar heel pain. This includes not only runners, but casual and work footwear as well.

LONG TERM 

• Strengthening (if indicated)

Reduced strength and mass of foot intrinsic muscles has been associated with plantar heel pain and plantar fasciopathy. Like other muscles, these can be strengthened. Strengthening of foot musculature can help direct load away from affected tissues (i.e., plantar fascia).

• Shockwave Therapy

If symptoms are persistent, there is evidence suggesting the use of shockwave therapy.

• Weight management

Consulting with a dietitian may be useful if body weight is determined to be a significant contributing factor.