Heel Pain (Plantarfasciitis)

Pathophysiology

The Plantar Fascia runs underneath each foot, stretching from the bone at the back of the ankle to out towards the toes. Plantar Fascia pain occurs in both athletic and non-athletic populations and although it is seen in all ages, is more common between 20-34 years old.

There are several risk factors which contribute to plantar heel pain:

• Limited ankle movement

• Being overweight

• Running and work-related weight bearing activities

• Long distance walking

• Repeatedly getting in/out of vehicles

Symptoms

• Pain on the bottom of the foot, often worse at the heel

• Pain with weight-bearing e.g. standing and walking

• Usually worst first thing in the morning on waking and improves with initial movement

• Pain worse after a period of inactivity

Management

• Activity modification and offloading e.g. avoiding prolonged standing or walking

• Heel cups to reduce pressure

• Ice rolling using a frozen water bottle

• Pain relief

• Physiotherapy including range of movement exercises and a graded strengthening programme

Investigations

Not generally indicated