We understand how frustrating that niggling pain on the bottom of your heel can be. The good news is that with the right approach at the right time this does not need to be a lasting issue for you. So I want to start by giving you a better understanding of what that pain is and what we can do to fix it or at the very least, manage it.
There are lots of different types and causes of heel pain, but let’s talk horses before zebras. The most common type we see come through the clinic is pain on the bottom of the heel. This is most commonly caused by strain at the insertion of the plantar fascia called plantar fasciopathy (more commonly known as plantar fasciitis).
Do the following symptoms resonate with you?
- Sharp pain on the bottom of the heel, worse in the morning when you first get out of bed (we call this “first step pain”).
- The pain comes good as your foot “warms up”, but then worsens progressively throughout the day.
What should you do if you experience pain on the bottom of your heel?
We have learnt that the longer you leave pain, the harder it is to fix. So we encourage you to seek advice from a Podiatrist as soon as possible to get you on the right track from the start. Evidence supports that someone with heel pain for longer than 8 months, will have a significant impact for their prognosis with conservative treatment.
Evidence also supports that heel pain generally needs combination therapy, ie. one treatment will take you 40% of the way, another might take you 30% and another couple may take you the rest of the way. A podiatrist will help guide you through various treatments and work out which one’s your body will respond to.
What treatments may be necessary?
- Offloading the painful area with taping or orthoses
- Cushioning – sometimes but not always! Your podiatrist can help you work this out, so don’t be fooled by buying really squashy and cushioned shoes straight away!
- Shockwave – this can break up scar tissue, interrupt pain cycles and stimulate increased blood flow to the area. Find out more in our shockwave therapy
- Footwear changes – speak to a podiatrist about appropriate brands and features, what seems like the logical or intuitive option, is not always the best! The wrong choice can make your symptoms worse.
- Strengthening – some of the most effective exercises are based around strengthening. Some can be very simple – try scrunching your toes and holding for 10 seconds, x10 reps, 3x daily.
- Dry needling and/or deep tissue massage of calves – calf muscles wrap down around the ankle and into the foot, they help the plantar fascia. When calf muscles are tight, the plantar fascia also becomes tight and has to work harder.
- Calf stretches
