Plantar Heel Pain

What are some common symptoms of heel pain?

Do you ever experience this annoying pain at your heel that never seems to go away?  Is there pain in the heel especially with your first step in the morning upon getting out of bed? Or perhaps feeling heel pain when standing up after sitting for a long period of time?

Urgghh!! What is that nagging pain at your heel?! It is most likely plantar heel pain!

What causes plantar heel pain?

The heel is the largest bone in the foot, and is often prone to injury due to overuse. Heel pain may range from mild to disabling, depending on the severity of the condition. The pain may be caused by inflammation, trauma, or a systemic disease such as rheumatoid arthritis.

We explain 2 common conditions that often lead to heel pain – plantar fasciopathy and Achilles tendinopathy.

1. Plantar fasciopathy

Plantar fasciopathy refers to an inflammation of the plantar fascia, which is a thick fibrous band that connects your heel to the front of your foot.

The plantar fascia is a thick elastic sheet that extends across the sole of our foot. This thick elastic sheet plays an important role in stabilising and supporting the arch of our foot, as well as dissipating impact/ force as we land while running/walking.

When it is inflamed or torn, putting pressure on the foot may result in sharp pain. Plantar heel pain or “plantar fasciopathy” usually develops when the plantar fascia tissues are overloaded beyond its capacity. What does that mean? It can be from spikes of sudden increment in weight-bearing activities/ training at large volumes (i.e long hikes, runs), or even those with occupations requiring long hours of walking or standing.

Symptoms of plantar fasciopathy

Plantar fasciitis causes pain in the bottom of the heel, which extends into the arch of the foot. The intensity of pain may vary; the pain may be sharp or may feel like widespread soreness in the area surrounding the heel and the arch. A common symptom of plantar fasciopathy is a stabbing pain that occurs when you take your first steps in the morning. The pain usually decreases as the day progresses with use of the foot, but may return after long periods of standing or when you stand up from a sitting posture. This is usually called the warm-up effect of the fascia.

Who is at risk of plantar fasciopathy?

While the cause of this condition is unclear, there are factors that can increase your risk of developing plantar fasciopathy:

• Age – the condition is more common among those aged 40 – 60
• Flat feet, high arches, or tight calf muscles
• Obesity – extra pressure on your feet due to significant body weight
• Medical conditions such as arthritis
• Exercises that repeatedly impacts the plantar fascia such as running
• Standing for extended periods
• Wearing high-heeled shoes