Foot Pain and Heel Pain

Plantar fasciitis

The plantar fascia is a thick, fibrous band of connective tissue that is found on the bottom of your foot. It originates from the bottom surface of your heel (calcaneus bone) and extends along the sole of your foot towards the toes. This connective tissue acts as a shock absorber of the foot.

Plantar fasciitis is a condition of overuse where repetitive activity on your feet can result in the plantar fascia becoming tight, and causing persistent traction on its origin point in the heel bone resulting in inflammation. Plantar fasciitis commonly presents as sharp pain on the inside part of the heel that is worse in the morning with the first few steps.

Your physiotherapist will assess you to determine what factors may be causing this condition. Initial treatment will consist of relieving pain and decreasing inflammation by rest, ice, and protection (i.e. heel cups, orthotics, strapping of the foot). Rehabilitation will then involve correcting biomechanical insufficiencies, stretching tight muscles, strengthening the intrinsic muscles of the foot, and a gradual return to normal activity.

Achilles Injuries

The Achilles tendon is the large tendon found on the back of the ankle. This tendon connects the leg muscles to the foot and enables you to push off while walking and running.

Two common injuries that can occur to the Achilles tendon include Achilles tendinopathy and tearing or rupturing of the tendon. Achilles tendinopathy was commonly known as Achilles tendinitis, however research has found that this is a misnomer as this condition does not have an inflammatory component. In actuality, tendinopathy is due to a series of micro tears that weaken the tendon.

Signs that you may have Achilles tendinopathy may include:

• Moderate to severe pain in the Achilles tendon area
• Stiffness in the tendon that diminishes as you use the foot/lower leg more
• Reduced strength and/or movement in the foot lower/leg
• Morning pain and stiffness in the Achilles tendon area

An Achilles tendon can be subject to partial tearing, or a complete rupture. Where a partial tear can mimic symptoms similar to those of a tendinopathy, a complete rupture of the ligament will result in immediate pain, loss of strength and movement. The pain felt with a complete rupture is commonly described as being shot or kicked in the back of the leg.

Achilles tendinopathy is often a chronic condition that will take time to treat. See your physiotherapist as soon as possible if you suspect tendinopathy such that they can determine the severity of the condition, and to provide advice on the rehabilitation required.

If your Achilles tendon has completely ruptured, this is most often managed surgically. Following surgery, the Achilles tendon will then require an intense rehabilitation, stretching and strengthening program which will be guided by your physiotherapist.