Heel Pain and Plantar Fascitis


Heel pain is a common condition in which weight bearing on the heel causes extreme discomfort. Foot mechanics play an important role in how the condition develops or improves.


There are three different categories of heel pain, the first is caused by an over-use repetitive stress which refers to a soreness resulting from too much impact on a specific area of the foot. This condition often referred to as 'bruised heel syndrome' can be caused from shoes with heels that are too low, a thinned out fat pad in the heel area, or from a sudden increase in activity, or bruising. Rest is often the best form of treatment for this.

Plantar Fascitis


A more common diagnosis of heel pain, is usually caused from a biomechanical problem such as over-pronation (flat feet). The Plantar Fascia is a broad band of fibrous tissue that runs along the bottom surface of the foot, from the heel through the mid foot and into the forefoot. Over-pronation can cause the Plantar Fascia to be excessively stretched and inflamed resulting in pain in the heel and arch areas of the foot. Often the pain will be most intense first thing in the morning or after a prolonged period of rest, the pain will gradually subside as the day progresses. Conservative treatment using triple therapy is very succesfull. This involves orthoses to support and rest the plantar fascia, paterior leg splints to be worn at night to apply a gentle stretch and stimulate healing. In difficult cases an injection to reduce inflamation will form the third part of the triple therapy. In rare cases surgery may be considered.
Heel pain in children under the age of approximately 13 may be due to Plantar Fascitis. However it may also be due to a condition known as Sever's Disease. This occurs in children who are very active in sports and who have regular and large growth spurts. Pain is usually present at all time from the outset and is evident all around the heel. The heel may also show signs of redness, some swelling and warmth. This condition is caused by an inflammation of the bone and cartilage. The use of orthoses and leg splints helps considerably and in severe cases applying a below knee plaster cast has been advocated.

 

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