ADVICE

Plantar Fasciitis (Heel Pain)

If you feel pain in the sole of your foot, particularly on the inside of your heel and especially in the morning, it could be a sign of plantar fasciitis. The pain is usually worse in the morning or after prolonged periods of sitting and may radiate down the length of the foot. It tends to ease once you get up and walk around as the muscles and soft tissue of the foot and lower leg stretch out.

The plantar fascia is a thick band of connective tissue that runs along the sole of the foot from the heel bone (calcaneus) to the base of the toes. It’s there to support the foot arch and distribute the impact of walking and running.

Whilst plantar fasciitis is often thought of as a running injury, it’s frequently found in people over 40, although being overweight can also increase your chances of suffering. It’s advisable to treat the problem quickly, before it becomes chronic, after which it’s difficult to alleviate.

There are several causes of plantar fasciitis. Most often it’s a gradual build-up of tiny micro-injuries culminating over time in a debilitating pain in the heel.

Tight calf muscles are a major contributor to the problem since they attach via the Achilles tendon, to the calcaneus, exerting more force on the heel bone.

Biomechanics also play a role in plantar fasciitis. Weak glutes (muscles in the bum) can cause the foot to over-pronate (roll in), which may lead to over-stretching of the plantar fascia. However, the opposite problem, over-supination (rolling out) of the foot means impact is insufficiently absorbed causing damage to build up over time.

There are several things you can do to prevent and treat plantar fasciitis: –

Stretching the calf muscles is really important – make sure you stretch with a straight and bent leg, which will ensure you target the two main calf muscles (see diagram below). Hold each stretch for at least 30 seconds and repeat at least once or twice a day.

Self-massage – massage the sole of your foot by rolling it over a round or cylindrical object like a ball, rolling pin, can of soup or similar. Just roll your foot repeatedly over the object, whilst gently increasing the downward pressure.

Wear supportive footwear. Sandals or flip flops can exacerbate the problem.

If you’re a runner who is already suffering, you should cease running until you are pain-free. If you aren’t suffering and are training for a race, don’t increase the mileage too quickly – no more than 10% a week.

Runners should consider having their gait analysed to ensure their running shoes are the correct type for your gait.

Finally, visit your local sports massage therapist who should be able to identify the main cause of your heel pain, treat the problem and recommend rehabilitative exercises.