Plantar heel pain rehabilitation – offload, but not too much….

Pain on the bottom of the heel is a common complaint. It frequently presents in the absence of a specific injury, but may be associated with excessive load. There are many tissues under the heel that can be injured, such as the plantar fat pad, branches of the tibial nerve, the heel bone – but the most commonly injured tissue is the plantar fascia. The plantar fascia is a dense tendon-like structure that runs from the heel to the toes. It is responsible for maintaining the arch of the foot and aids in propulsion. Injury to the plantar fascia can result in swelling, tearing or rupture. The plantar fascia is subjected to load via (1) compression (being squashed between the heel bone and the ground) and (2) tension (being stretched longitudinally).

In order to rehabilitate the plantar fascia, moderating the loading is essential. A reduction in compression can be achieved by shifting weight to the front of the foot. This can be done by wearing arch supports (orthotics) as they increase the contact area of your foot with the ground, relatively taking weight away from the heel. Moderating tensile strain, however, requires active controlled exercise.

At Adelaide Podiatry Clinic we have developed an adjunctive rehabilitation regime to assist in reducing pain. If you have difficulty with heel pain, make an appointment to discuss your treatment options.