Heel pain, plantar fasciopathy

Plantar fasciopathy is inflammation of the tissue beneath the heel bone where the muscle tendon of the sole of the foot is attached. Inflammation of the heel fascia may be due to several reasons: malpositions of the foot, tightness at the back of the foot, uncomfortable shoes, overweight or standing or walking on a hard surface for long periods of time. Other structures in the heel area may also get sore due to stress and incorrect walking style or position. 

Plantar fasciopathy typically causes a stabbing pain in the middle of the heel. Putting strain on the heel worsens the pain, whereas rest alleviates it. Pain is often at its worst in the morning when starting to move, after which it may ease briefly. Swelling is not a common symptom of plantar fasciopathy – the heel looks normal. 

Self-care

• The key is to reduce the strain that is causing the pain.
• Take up pain-free exercise, for instance in water.
• Use sturdy shoes and silicone padding beneath the heel to reduce pressure on it. 
• When the heel is inflamed, you should avoid walking barefoot, even at home.
• Rub and stretch the sole of the foot using a ball.

When should you seek treatment? 

See a doctor if the heel pain is associated with a trauma, such as a fall.

When should you see a physiotherapist?

Physiotherapy may be helpful if the symptoms are prolonged and the self-care instructions do not help.

Source: The Finnish Medical Society Duodecim

FSHS Physiotherapist / 24 February 2023