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PLANTAR FASCIITIS HEEL PAIN

Plantar Fasciitis may present as pain anywhere along the sole of the foot, particularly along the arch and just in front of the heel. 

The most common cause of deep pain on the bottom surface of the heel, is plantar fasciitis (inflammation of the plantar fascia). The plantar fascia a broad band of fibrous tissue which runs along the bottom surface of the foot, from the heel to the toes. It is just below the skin and subcutaneous fat.

It helps to secure the arch. Long standing inflammation causes the deposition of calcium at the point where the fascia inserts into the heel bone. This results in the appearance of a bony heel spur on x-ray. The spur itself is not the source of the pain. Stubborn heel pain should be evaluated by your Physical Therapist.

Symptoms
Sharp pain often localized to the bottom and/or inside margin of the heel
Often worse on arising in the morning and after rest
Aggravated by prolonged weight bearing and ambulation
May severely limit activities
Most common in middle-aged and overweight adults, and athletes

Causes
Excessive load on the foot from obesity or overuse    
Excessive flattening of the arch on weight bearing                                                                        
Tight plantar fascia, common in persons with high arched feet
Over pronation of the foot (a complex motion including outward rotation of the heel and inward rotation of the ankle).

What you can do
Application of ice to the heel area after prolonged activity
Wear supportive shoes with a stiff heel counter (the part of the shoe which wraps around the heel) and a good arch. A well made running or walking shoe is a good example.
Sometimes a shoe with a moderately high heel will relieve pressure on the fascia
Stretching and strengthening exercises will stretch the plantar fascia and strengthen the small intrinsic muscles which stabilize the arch. This should not be attempted when the heel is sore.

What the Physical Therapist may do
Apply taping  to relieve strain on the plantar fascia
Administer physical therapy / Laser Therapy
Control foot function with Prescription Orthotics
Prescribe special splints to help stretch the fascia

Other causes of heel pain
Various types of arthritis
Trauma to the heel
Inflammation of the tendons around the heel
Heel Neuroma (benign tumors of the nerves around the heel)
Abnormality in the shape of the heel bone
Foreign body in the heel (e.g. splinter)
Inflammation of the heel bone (calcaneal) growth plate in children