Pain around the heel can been one of a few things. It is VERY IMPORTANT that you get the correct diagnosis, as all of the following pathologies are often diagnosed as Plantar Fasciitis, and much of the time, the diagnosis is WRONG. In my opinion, the best person to properly diagnose you pain is a PHYSICAL THERAPIST with the proper training; the reason is that the PT is educated in the study of movement, rather than focusing on a diagnose based on the location of the pain. Common pathologies that can cause symptoms of pain in the heel:
Flexor Hallucis Longus Tendinitis
Posterior Tibialis Tendinitis
Calcaneal Fat Pad Irritation
The purpose of this article is NOT to learn how to do differential diagnosis for the 5 above pathologies. I strongly suggest that if you have pain in the heel of your foot, that you seek a Physical Therapist as your primary point of contact. PHYSICIAN REFERRAL IS NOT REQUIRED. Plantar Fasciitis: COMMON CAUSES
Improper shoe wear
Usually involved in people (more common in women) who wear low profile shoes (aka “flats”) with no support or assistance in shock absorption.
If this is thought to be the main cause of the Plantar Fasciitis, it is important to get the biomechanics of your gait assessed to determine the best shoe wear for you.
Improper joint mechanics
This NEEDS to be assessed by a qualified physical therapist. MDs and Podiatrists are NOT educated in this topic.
There is a very specific way that the several joints in the ankle and middle of your foot are suppose to move and interact with one-another. If this is not happening properly, it causes compensations in the way you move when walking, and Plantar Fasciitis can absolutely be caused by this issue.
Treatment is doing appropriate manipulations of the ankle and foot to normalize the way they move, and eliminating the cause of your plantar fasciitis.
People who ALWAYS wear high heels are likely to develop tightness in their plantar fascia, as well as in their calves. Also, people who sit for long hours are also likely to develop these issues. Finally, when we sleep, our feet are usually pointed, and this can add to further tightness in our plantar fascia and calves; upon waking in the morning and taking your first few steps there can be sudden pain in the back of the ankle and/or heel.
Treatment for this is to get soft tissue manipulation of the calf and plantar fascia to help the flexibility of the tissue, and to also wear a night splint to assist in stretching.
The arch of our foot is created by the natural bone structure, but assisted with ligament and tendon support. There are little muscles in the bottom of the foot and between the long bones of the foot. When these muscles are not working properly, the arch of the foot can drop and begin to strain the plantar fascia.
The treatment for this is to identify which muscles are not working properly, and to re-educated them to contract better.
I hope this helped you to better understand the possible causes for Plantar Fasciitis, but to also help you realize that pain in the heel and arch is NOT always plantar fasciitis. In fact, about 50% of the time its NOT plantar fasciitis, but a different pathology. Again, its VERY important to get the proper diagnosis and treatment for your condition. Since we are creatures that spend so much time on our feet, pain in this area of the body rarely gets better if left untreated…in fact, it usually progresses to get worse. If you or someone you know has been experiencing Pain in Your FOOT, contact info.JLPT@Gmail.com or 646-455-1312, and I’ll give it a thorough assessment and further show you how it can be treated to finally solve the source and cause of your pain.