There are many causes of heel pain but one of the biggest causes is plantar fasciitis which affects under the heel of the foot. Plantar fascia symptoms are generally reported as being worse in the morning or after periods of rest, and symptoms can last several months. A podiatrist can take a look at your heel and should be able to assess whether they believe it is plantar fasciitis or another form of heel condition. If you are sure you have plantar fasciitis there are some exercises you can do at home to help.
The best exercise may vary from person to person but rolling your foot on a ball and carrying out calf stretches are effective in helping plantar fasciitis.
The ball helps massage and stretch the fascia structure. You can use a small ball such as a tennis or golf ball and it can be done while sitting down at home or under your office desk. Doing this regularly throughout the day can make a difference
Calf stretches reduce flattening of the foot which aggravates the fascia. Calf stretches can be carried out by slowly lowering your heels off a step, where you will feel a stretch in your calf muscles. If you hold the stretch for 20 seconds and then repeat a few times throughout the day, this should also gradually help your symptoms.
The first few steps after sleeping are typically the most painful but after several steps of walking the pain usually improves. Long walks though can aggravate the fascia so it is best to keep walks short and gentle until symptoms are improving.
Try using good supportive shoes like a trainer and some arch support from an insole. A podiatrist can assess your foot, the way you walk and your footwear, and then give you advice based on this. The higher the impact of activity the more likely it will aggravate the fascia, you should certainly avoid running and jumping exercises.
Most cases resolve within 6 months but some cases can be longer than this, especially if both heels are affected.
However, treatments should significantly speed up the healing time where you feel a gradual improvement each week. To improve your recovery it is best to use good footwear, support the arch, and avoid high impact activities like running and jumping exercises.
Plantar fasciitis can always return but there is usually a reason why it developed in the first place. A podiatrist should be the best person who can assess you and your foot. They should be able to identify some of the reasons you developed it and guide you on how to reduce the chances of it returning.
Carry out all the exercises listed above and see a podiatrist who can help you treat the condition and help reduce the chance of recurrence. This may also include reducing your body mass index if it is high, and wearing supportive shoes and insoles.
Some of the treatments you that may be advised include:
Custom orthotics are made by taking a mould or 3D scan of your feet. They are designed to fit your shoes so that they support and stabilise your feet. These have been proven to help symptoms within 1 to 3 months.
Shockwave therapy administers shocks to the area which encourages blood flow and healing time. The shockwaves are mechanical and not electric, they are audible, low energy sound waves, that work by increasing blood flow to the injured area.
Success rate of this treatment is around 80%. Typically your specialist will suggest one session a week over three weeks, though further sessions may be advised following the initial batch.
Steroid injections are injected to the area and can help reduce inflammation and pain. This tends to be a good treatment in the short term. Further injections can be carried out at a later stage should symptoms deteriorate again.
PRP injections are carried out by spinning a sample of your own blood at a high speed to separate the different types of blood cells. The plasma and platelets are drawn out and injected into the area, this increases concentration of platelets and growth factors at the site of injury by up to 500%. PRp injections use your body’s natural healing cells, it is a new field of medicine but evidence is growing and looks very good for the mid and long term.
Your podiatrist will assess the underlying cause of your heel pain and discuss the most appropriate treatment plan. This may include a combination of the treatments outlined above to provide the most beneficial outcome.