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Plantar Fasciitis
Heel pain is probably the most common and disabling foot problem in Australia today. Since the heel is the largest bone in the foot, it bears the most weight when you walk. Weight gain, aerobics, standing at work and many other activities such as constant walking and standing can all put a large amount of stress on the heel bone. This can cause pain and often a bone spur forms on the bottom of the heel.
Probably the most prevalent of heel problems is a condition known as Plantar Fasciitis. The Plantar Fascia is the thick, inflexible fibrous material on the bottom of the foot connecting the toes and the heel.
A painful tearing of the plantar fascia may result in either plantar fasciitis or a heel spur. Plantar Fasciitis is an inflammatory condition of the Plantar Fascia usually due to strain or overuse. The pulling away from the bone may result in a heel spur as the bone attempts to heal itself by producing new bone.
A heel spur is a point of excess bone growth on the heel. The bone growth usually extends forward towards the toes. Heel spurs are visible on X-ray. It is important to note that the heel spur is the RESULT of the problem and not the CAUSE!
Without treatment the pain will usually spread around the heel. The pain is usually centred at a location just in front of the heel toward the arch. When the tearing occurs at the bone itself, this results in the development of a heel spur. Without the spur the condition is called plantar fasciitis.
Cause
The most frequent cause is an abnormal motion of t
he foot called excessive pronation. Normally, while walking or during long distance running, your foot will strike the ground on the heel, then roll forward toward your toes and inward to the arch. Your arch should only dip slightly during this motion. If it lowers too much, you have what is known as excessive pronation.
Treatment
Plantar fasciitis is usually controlled with conservative treatment. The treatment plan includes carefully following a program of physical therapy and strapping of the feet. Following control of the pain and inflammation, orthotics (custom made shoe inserts) may be used to stabilize your foot and prevent a recurrence. The majority of the time heel spurs and plantar fasciitis can be controlled by this treatment and surgery can be avoided. The Orthotics prevents excess pronation and prevents lengthening of the plantar fascia and continued tearing of the fascia. Usually a slight heel lift and a firm shank in the shoe will also help to reduce the severity of this problem.
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