Plantar heel pain, also known as plantar fasciitis, is a common foot condition.
Plantar heel pain causes discomfort and sometimes inflammation of the thick band of tissue (fascia) that runs across the bottom of each foot and connects the heel bone to the toes.
You are more at risk of having plantar heel pain if:
- Recently started or a sudden change / increase in activity (long standing or started running)
- Have a tight calf or heel region
- Sudden overstretching of the sole of your foot
- Wear shoes with poor cushioning or support
- Are overweight
The most common symptoms associated with plantar heel pain may include:
- Pain is often felt on the underside of the heel where the foot strikes the floor when walking
- A sharp stabbing pain or bruising sensation on the underside of the heel
- Pain where the heel strikes the floor when walking.
- Pain / stiffness is often worse first thing in the morning or after periods of rest
- Pain around the heel on long standing
- Increased pain with less supportive footwear such a flip flops
- In more severe cases the inability to place heel to the floor when walking
Diagnosis is usually made from a consultation with your Health Care Professional, involving a detailed history of the onset of symptoms, current pattern of symptoms and your current functional ability.
Images/scans are generally not needed to confirm plantar fasciitis. Further tests such as ultrasound scans may be performed if the Health Care Professional needs further information to finalise the diagnosis.
The primary aim of treatment is to help manage your pain. This allows you to move more and help you return to normal activities sooner. Initial treatment therefore is aimed at pain control. This might involve pain medication, or the use of heat or cold treatments.
Once your pain is under control, working on the movement and strength of your foot and ankle is what will help long term.
You can help to reduce pain, ease stiffness, strengthen your muscles and improve overall general fitness by keeping active. Below are some basic exercises specific to your foot to get you started.
- Wear shoes with cushioned heels and good arch support
- Use insoles or heel pads in your shoes
- Try regular exercises as shown below
- Staying healthy helps your recovery and maintain a healthy weight
- By reducing the load and impact on your feet, and follow the Keeping Active advice
It is normal to experience some discomfort when doing exercises, and individuals may start at different points. Pain should not increase excessively during or immediately after the activity. Discomfort should return to pre-activity levels 24-48 hours after the activity has finished.
The number (reps) and frequency (sets) of exercises suggested here are a guide, and should be performed to your personal tolerable pain levels. This means repetitions will vary between individuals and you should only go as far as is reasonably comfortable for you.
Heel raises with toes on a towel roll
Stand up straight facing a wall or supportive surface. Position a rolled towel on the floor. Place your toes onto the towel. Perform a calf raise, pushing up onto your toes. Hold this position briefly. Control the movement as you slowly lower your heels back down to the floor. Ensure you keep your knees straight throughout the movement.
Towel scrunch
Start in a seated position. Spread a thin towel on the floor in front of you and place your foot on the end of the towel. Keep your heel on the floor and use your toes to try to pull the towel towards you.
Plantar fascia ball roll
Start in a seated position. Place a small ball underneath the arch of your foot. Apply pressure down on the ball, and roll the ball from the base of the heel up to the base of the great toe.
You should also see a Health Care Professional if you:
- Have pain that doesn’t show any signs of improvement, within a couple of weeks of self help
- Have pain that has rapidly deteriorated or suddenly worsened despite self help
- Have pain, tingling, numbness or weakness in your feet
- Are feeling clumsy or are falling more often
- Have a history of inflammatory arthritis, immuno-suppression, cancer, Tuberculosis (TB), drug abuse, AIDS or other infection
- Feel unwell, have a fever, or unexplained weight loss
- Are experiencing significant and regular changes to your usual sleeping pattern
- Have a history of recent injury (e.g. from a road traffic accident or a fall) or a history of foot or ankle surgery
- Have a new and visible deformed or misshapen foot
- Have pain in the bottom of your foot that is severe or you are unable to put your heel to the floor
- Find the pain is getting worse or keeps coming back
If you do not have any of the above, you may be able to effectively self-manage your condition