Heel Pain Plantar Fasciitis And Achilles Enthesopathy

What is Plantar Fasciitis?

  • Plantar fasciitis is a common foot problem in sports participants and people that stand/walk for extended periods during the day. It starts as dull occasional pain in the heel which may progress to a sharp persistent pain. Classically, it is worse in the morning with the first few steps, or at the beginning of a sporting activity.
  • The plantar fascia is a thick fibrous band running the length of the arch from the heel bone to the ball of the foot. It is responsible for helping maintain the arch of the foot. It stretches to help absorb shock as the arch flattens with body weight.
  • With repetitive stress, such as prolonged standing, walking or running, the fascia becomes strained resulting in micro tears, most often where the fascia attaches to the heel bone.
  • Since it is difficult to rest, a vicious cycle is set up where the situation is aggravated with each step. In severe cases, the heel may become swollen. The problem progresses rapidly and is much easier to treat when it has just begun, rather then when it has become a chronic problem.
  • However, when the fascia is properly supported by an orthotic the tears are minimized and healing may begin.
  • When the fascia is pulled away from the bone the body reacts over time by filling in the space with new bone. This causes the classic heel spur. This heel spur is usually a secondary x-ray finding and is not the cause of the problem but rather a result of the problem.

What Causes Plantar Fasciitis: