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Not all heel pain is plantar fasciitis

Following on from ‘Myth Monday’ on this topic, we know that there are lots of possible causes of heel pain alongside plantar fasciitis (aka plantar fasciopathy or plantar heel pain).

In this blog, we will discuss plantar fasciitis, but also some of the other relatively common pathologies in the heel that we see in the Physiotherapy clinic. Getting the diagnosis correct is paramount to ensuring the optimal rehabilitation.

The plantar fascia is a strong ligament that runs from the heel bone to the toes. This ligament has to tolerate a significant load during everyday activities such as standing or walking. This can often become sore & irritated due to a number of factors related to a change in this load. This includes, but is not restricted to, changes in the biomechanics of the foot (due to arthritis or soft tissue changes), poor or incorrect footwear, a change in activity, being overweight or trauma. This is often termed ‘multifactorial’.

Heel pain could also arise from the heel fat pad, various tendons in the region, problems with the main bone on the heel (calcaneum) or the many smaller bones in the foot such as fracture, spurs or arthritis, or irritation of nerves in the heel region. Sometimes pain or different sensations like numbness or tingling in the feet may actually be referred from other parts of the body. This is sometimes called referred pain.

As pain in the heel area can be caused by so many different conditions, ‘plantar heel pain’ is now considered a more appropriate term. It is one of one of the most common lower limb musculoskeletal conditions that affects both sedentary and physically active people. It can have a significant impact on health-related quality of life, including work and activities

So if you have heel pain, it could well be plantar fasciitis, but it is well worth having a Physiotherapy assessment at Harbourside to determine if one or other of these alternative pathologies may be causing your pain. Getting the correct diagnosis will ensure the correct management of your pain.

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