Plantar Fasciitis – My Heel Pain is Killing Me

Heel pain is a killer. How many times have you heard someone say ”My feet are killing me!” Obviously, the pain isn’t killing you but it can such a massive affect on your daily life that it can prevent you from doing seemingly ordinary things like working and shopping. One of the most common heel pain ailments is call Plantar Fasciitis (pron: fash-ee-ahy-tis). It’s a killer from the moment you put your foot to the ground in the morning. This used to be called ‘Policeman’s Heel’ when policemen used to ‘pound the beat’.

Plantar Fasciitis is one of the most common injuries that walkers and athletes get and if not treated correctly it can mean an end to active walking or running. Unfortunately Plantar Fasciitis can also affect those that don’t exercise too. There are an awful lot of myths out there about Plantar Fasciitis. The condition is not caused by trauma or by the wrong shoes or by a heel spur.

Correctly diagnosing Plantar Fasciitis is a difficult task. There a few different types of heel pain that can mimic Plantar Fasciitis symptoms so a proper assessment is essential.

It is a mechanical condition. There a numerous variations to Plantar Fasciitis but the main one is a sharp pain in the inside/front portion of the heel bone that can extend into the midfoot.

The tissue that connects the heel bone and the joint of the big toe is your Plantar Fascia and is made from similar tissue to tendons and ligaments. It is the foundation of your arch. The Plantar Fascia has a limited flexibility which is needed as part of the ‘shock absorbing’ part of the arch as the foot pronates. Pronation is a combination of internal rotation of the shin, rolling of the heel and other foot movements.

When a person is an over-pronator the Plantar Fascia is over stretched. Remember this happens every time you take a step, so in a runner the problem is increased due to the increased mileage and force applied to the Plantar Fascia. However, even in a non-athletic person we average about 8000 steps every day.

Plantar Fasciitis doesn’t occur out of the blue, it builds up over years. The pain that people with Plantar Fasciitis experience occurs when the stretching of the Plantar Fascia has caused an inflammation of the attachment of the Plantar Fascia to the heel bone. The reason that Plantar Fasciitis is at its most painful, usually in the morning or after long periods of sitting down, is because the Plantar Fascia has had a chance to tighten again.

This is why any effective treatment needs to address the biomechanical deficiencies of your walking and running if conservative treatment is to be successful. Stretching, massage and taping may also be needed but it all depends on the individual case. Also, although bad footwear doesn’t cause Plantar Fasciitis, good correctly fitting shoes do ease Plantar Fasciitis so a running/walking shoe assessment is advised.

David Kingston is a Senior Orthotist that has worked with some of the country’s top athletes. He is in private practice at Leinster Clinic Biomechanics Lab in The Leinster Clinic in Maynooth