- Are you waking up first thing in the morning and hobbling as a result of heel pain?
- Is your walking capacity limited by heel pain?
- Have you been told you have plantar fasciitis, yet you’re not sure what to do about it and your heel pain is becoming chronic?
Let’s talk about heel pain! There can be many reasons for developing heel pain. Common reasons can include:
- Plantar fasciitis
- Achilles tendon problems
- Referral of pain from the lower back
Given that there are a few different causes of heel pain it is essential that you have a full assessment with a qualified professional like a physiotherapist in order to determine the cause of your symptoms. However here are some tips from the The Yoga Physio team to explain the most common causes of heel pain and steps you can take to start resolving your pain.
Let’s start by looking at plantar fasciitis.
The plantar fascia is simply a thick sheet of tissue on the sole of the foot that attaches onto the base of the heel. It helps support the arch of the foot. If the arch of the foot starts to collapse as a result of foot muscle weakness or poor footwear, then this can place a stretch load onto the plantar fascia where it attaches onto the heel. Over time this can create an irritation at the point of attachment, much like a point of weakness. This is typically aggravated with prolonged periods of standing or first thing in the morning. Common symptoms can include pain with waking up a first thing in the morning, pain with getting out of a chair for the first few steps and pain to walk on a hard surfaces or barefoot.
What you can do:
The first thing is to have an accurate assessment to figure out why you have developed your symptoms. Causes this can include tight calf muscles, poor footwear, loss of foot arch strength or control and weight gain.
Immediate steps you can try:
- Losing weight- if you have gained weight this can place additional load onto the plantar fascia
- Calf stretches- with a heel press in down dog or try this simple stretch here
- Supportive footwear
- A strengthening program also commonly needs to be prescribed by your physiotherapist
Achilles tendon problems
“Achilles tendinopathy” is a fancy name for Achilles tendon weakness. If you can imagine the Achilles tendon like a thick strong rope, if that rope becomes weak or to starts to “fray”, it can become a point of irritation as it rubs over the heel bone during your walking cycle. Pain is typically at the back of the heel rather than underneath the heel. Pain can extend up into the tendon or down low toward the base of the heel. Pain is usually worse after exercise or after periods of rest such as sleeping or sitting.
Causes for achilles tendinopathy can include:
- Poor footwear
- Weakness in the calf muscles or tendon
- A sudden increase in exercise such as returning to a running program
- Poor running technique including weakness in the hips resulting in overload of the calf and achilles
Tendons take time to build strength and if you do not have enough strength in your tendon in for the activities that you are, trying to do then this can contribute to the onset of symptoms and irritation at the attachment point.
What you can do:
Treatment for achilles tendon problems are usually be determined by the cause of the problem and also the chronicity of your symptoms. If you have only recently an on developed the onset of symptoms as a result of increasing your walking or running, then the best course of action is to rest and reduce your activity initially in order to manage some of the symptoms.
If your symptoms have been there for a long time then for the rest will not help! We know this because you’re worse first thing in the morning after sleeping and resting!
However activity levels need to be modified and a strengthening program needs to be started to rebuild some healthy tendon fibres in the Achilles. Try this exercise here as a starting point!
The important thing to remember is NOT to stretch your calf if you have achilles tendon pain! Although its tempting to ‘stretch it out’ , weak tendons do not like stretching and this can aggravate problems in the long term.
Weak hips contributing to your foot pain? Try our favourite hip strengthening exercises here!
The Yoga Physio is powered by Nichole Hamilton and her physiotherapy practice Synergy Physio. To learn more about her physiotherapy practice and her team at Synergy Physio click here
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