The most common cause of heel pain is inflammation of the plantar fascia at the front of the heel near the foot arch. The appearance of pain at the rear of the heel is usually associated with Achilles tendon inflammation.
Clinically the plantar fasciitis is diagnosed by palpation where a point of high sensitivity is identified, which coincides with the insertion of the fascia in the heel. In addition, the person usually reports difficulty and pain when walking on hard surfaces (e.g., wooden surfaces), first thing in the morning or after rest.
Prevention is the key to intervene before the symptom occurs or when discomfort first occurs. This is why knowledge of aggravating factors is needed. Specifically, sporting activities (such as running, jumping), activities on hard surfaces (walking, running, jumping), heel trauma as well as inappropriate footwear that does not provide long-term support (eg flip flops). Obesity, age and gender (more often women) are also risk factors.
Treatment following a diagnosis for plantar fasciitis may be conservative and with the use of injections (like steroids or PRP). Physical therapy is an integral part of recovery. By following the right steps at the right time, recovery can work very well. Various treatments for pain relief are used in physiotherapy and may be useful in the early stages of the problem (ice, taping etc). The main goal is to increase the endurance of the plantar fascia. At this stage, rehabilitation is based on methods such as manual therapy, hold-relax exercises, isometric exercises and other stretching exercises. But above all, stretching of the facia and the Achilles tendon and strengthening both the affected area (the sole muscles) and the lower limb kinetic chain in general is the key to treating plantar fasciitis. This results in better limb functionality and protection from re-injury of the area through gradual exposure to the activity.
Sometimes, orthotics (insoles) are suggested to support the arch and the fascia. The physiotherapist will be able to advise you on that.
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