Heel Pain

Generally, you’ll notice the common symptoms of pain first thing out of bed in the morning or getting up after prolonged rest. This pain will ease after subsequent steps throughout the day.

Some other symptoms you may experience include:

Sharp, stabbing pain in the heel, typically worse in the morning or after periods of rest.

Pain may subside or lessen with activity but can worsen after prolonged standing or walking.

Tenderness or soreness along the bottom of the foot.

Stiffness or aching in the foot.

Pain may radiate from the heel to the arch or the ball of the foot.

Overuse or repetitive strain: Activities that involve prolonged standing, walking, or running can put excessive stress on the plantar fascia.

Foot mechanics: Abnormal foot mechanics, such as flat feet or high arches, can increase the likelihood of developing plantar heel pain.

Improper footwear: Wearing shoes that lack proper arch support or cushioning can contribute to the development of heel pain.

Obesity: Excess weight puts additional strain on the plantar fascia and can increase the risk of developing plantar heel pain.

Age: Plantar heel pain is more common in middle-aged and older individuals.

Short term management

Rest: Avoid activities that exacerbate the pain and give your foot time to heal.

Ice therapy: Apply ice packs to the affected area for 15-20 minutes several times a day to reduce inflammation.

Pain relief: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help relieve pain and reduce inflammation.

Stretching and strengthening exercises: Perform exercises that stretch the calf muscles and strengthen the foot and ankle muscles to help alleviate the strain on the plantar fascia.

Extracorporeal shock wave therapy (ESWT): ESWT may be recommended to stimulate healing and reduce pain symptoms for both short and long term heel pain. The level of evidence and research conducted on the use of ESWT is vast showing positive results. 

Footwear modifications: Wear supportive shoes with good arch support and cushioning and consider using orthotic inserts or shoe inserts to provide additional support.

Orthotic therapy: custom-made shoe inserts to provide support, correct foot posture, support the fat padding under heal and assist with distributing pressure evenly.

Long term management

Night splints: Using a splint that keeps the foot and ankle in a dorsiflexed position overnight can help stretch the plantar fascia and reduce morning pain.

Physical therapy: A physical therapist can provide specialized exercises, manual therapy, and other treatments to promote healing and improve foot mechanics.

Weight management: If overweight, losing weight can reduce the strain on the plantar fascia.

Corticosteroid injections: In some cases, corticosteroid injections may be used to alleviate pain and reduce inflammation, but these are typically reserved for severe cases that have not responded to conservative treatments.

It’s important to consult with a healthcare professional, such as a podiatrist or orthopedic specialist, for an accurate diagnosis and personalized treatment plan for plantar heel pain.

Plantar Fasciitis is the most commonly diagnosed condition which is linked to poor postural alignment, weak intrinsic muscles of the feet, inadequate support in footwear, poor quality footwear and muscle imbalances to name a few. Other considerations for heel pain may include; – Plantar Calcaneal heel spur (heel spur) – Neural-based heel pain – Fascial tear/ rupture – Lower back pain/ lower back dysfunction – Thickened Plantar Fascia – Degenerative change to the plantar fascia – Calcaneal (heel bone) stress fracture – Plantar fibromatosis – Seropositive rheumatoid disease – Seronegative inflammatory joint disease – Changes to fat padding under heel (oedema, atrophy). Check out our other section ”Rearfoot pain” for more information.

Great news! Your heel pain can be treated in a ‘conservative’ manner as opposed to ‘surgical’ intervention. Okay, but how will a CUSTOM pair of foot orthotics help? Traditionally, foot orthoses are prescribed for heel pain management on the idea of altering foot function through control of your rearfoot (heel) and support of your MLA (Medial longitudinal Arch) resulting in reducing tension in the plantar fascia and associated soft-tissues, with current research on the benefits of foot orthoses continually increasing to provide pain relief, improve function and reduce disability.

According to research from Landorf (2015), CUSTOM foot orthotics are beneficial for the short and medium term relief of pain and improvement in function. Pre-fabricated innersoles that you can get on the shelf of your local sport’s store or chemist aren’t a bad option and can be a great short-term solution in varying situations. Choosing between the two options is often going to depend on a few factors such as: cost of orthotics, occupation, activity and footwear; practitioners beliefs surrounding the orthotic use; material type and construction method.