Plantar heel pain
There can be many causes of pain under the heel, but probably the most common one is irritation to the plantar fascia – sometimes called plantar fasciitis.
The plantar fascia is a band of thick tissue which runs from your heel bone to your toes. If you bend your big toe back, you should see it become prominent on the sole of your foot.
It helps to support the arch of your foot, but if it gets overloaded it can become thickened and cause discomfort under your heel and along your arch.
On the picture below you can see the bands of the plantar fascia, with the star indicating the most common site of pain.
A classic symptom of plantar fasciitis is pain on the first steps after getting up from a period of sitting or first thing in the morning when getting out of bed. It can be most painful under the medial plantar aspect of the heel pad – the area starred in the picture above. Sometimes this pain eases off a little when walking, only to come back again when you stop for a rest.
So what causes Plantar Heel Pain (Plantar Fasciitis)?
- Long periods of standing or walking or a sudden increase in activity levels (overuse).
- Being overweight will increase the load going through the foot, putting more pressure on the plantar fascia.
- Inappropriate footwear tightness/ weakness of the lower leg muscles
It is therefore important to maintain strength and flexibility in the muscles of the feet and legs to help manage and prevent the symptoms of plantar heel pain.
What can help?
- Adequate rest/ reduction of activities.
- Weight Management
- Appropriate footwear – this is important to help support the function of the plantar fascia. A trainer or a shoe with a cushioned sole can be very helpful.
- Stretching and strengthening exercises as shown in the video links below.
- A small heel raise or heel cushioning may help to reduce the pain whilst you are doing the rehabilitation. However, if they are uncomfortable or increase symptoms, then stop wearing them.
- If symptoms do not resolve, a Podiatrist may provide orthotics for additional foot support that may be beneficial.
The videos below show exercises that may be useful in strengthening the muscle to help it cope better with the demand that you are placing on it.
Don’t expect things to improve overnight though. It takes time for muscles and joints to adapt and get stronger.
Patient information leaflet
Please note: That pain will not resolve overnight and it may take up to 12 weeks or longer for symptoms to resolve.
If you do not see any sign of improvement after 12 weeks of following the advice and exercises you may need to get referred to a Podiatrist for professional help and advice.