Plantar fasciitis
The most common cause of heel pain. It hurts most in the first steps of the day and eases after walking for a while.
The plantar fascia is a band of fibrous tissue running from the heel to the base of the toes, supporting the arch of the foot as you load it. When it is overloaded it becomes irritated where it attaches to the heel, and that produces the characteristic pain: the first steps out of bed hurt a great deal, it eases after walking for a while, and it returns on standing up after sitting.
It rarely has a single cause. Usually several things add up: a recent increase in activity, footwear with no support or badly worn, a change of surface, extra weight, or a way of loading the foot that makes the fascia work harder than it should. That is why the approach starts by working out which of those is pulling on the heel in your case, rather than treating the heel on its own.
What is examined and what is done
- The exact location of the pain and the times of day it appears.
- Examination of the fascia, the Achilles tendon and ankle mobility.
- Assessment of loading and walking, to see what is overloading the fascia.
- Review of footwear and of activity over recent weeks.
- Offloading measures and, where appropriate, insoles to redistribute the tension.
Does your heel hurt when you first put your foot on the floor in the morning?
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