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Heel Pain

It is not uncommon for us to see people presenting with “heel spurs”.
Did you know that while heel spurs are seen in 45-50% of the population, about 1/4 of these will ever experience pain AND heel pain can occur just as commonly without a spur? Sometimes, seeing a spur on Xray doesn’t help our diagnosis at all!

PLANTAR FASCIITIS
Heel pain is commonly diagnosed as plantar fasciitis. The plantar fascia is a ligament, like a bowstring, that stretches taut under your foot to help keep the arch shape of the foot when standing. Too much load causes wear and tear. The wear and tear causes pain where the ligament joins to the heel.
However, when we see plantar fasciitis that is not getting better, it will often be because there are other structures that can cause the pain as well.

WHY IS MY HEEL SORE?
The foot is a very complex structure and requires a number of “helpers” to keep its arch. Tendons, bones, muscles and ligaments all play their part.
Any increased load through the foot can result in overuse of any or all of these structures.
Increased load happens when you increase your activity, have less support from your footwear, gain body weight or have an injury that alters your walking patterns.

WHAT CAN I DO?
If you develop heel pain, we suggest icing regularly, rolling a golf ball under the arch of your foot (not on the sore spot), wearing good supportive shoes and LOTS of calf stretching.
Anti inflammatory tablets can also sometimes help.
There are a number of taping techniques that can help with the pain, as well as gel inserts or possibly orthotics.

AND IF THAT DOESN’T WORK?
Make sure you check the diagnosis first.
If your diagnosis is definitely plantar fasciitis, there are more treatments that may be suitable. Many of these will need your Doctor’s help. Iontophoresis, corticosteroid injections, shock wave therapy and even PRP (platelet rich plasma) injections might be indicated.
If your diagnosis reveals that there are other structures causing or contributing to your pain, you may need further investigation to confirm this and possibly additional or other treatments to allow you to achieve complete recovery.

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