Heel pain can stem from any number of causes, but by far the most common is a condition known as Plantar fasciitis, or Plantar Fasciopathy if we are getting technical. Often associated on x-ray examination with heel spurs, and characterised by pain on the first step when getting up in the morning or after long periods of sitting.
The plantar fascia/plantar aponeurosis is an active, flexible band of tissue which runs along the bottom of the foot from the heel to the ball of the foot.
The role of the plantar fascia is two-fold:
When making initial contact with the ground, the foot undergoes a movement called pronation. The heel makes initial contact with the ground on the outside of the foot and rolls in towards the big toe on the inside. During this movement, the plantar fascia acts like a spring, where it lengthens, absorbing and storing the force of the foot hitting the ground.
As your foot prepares to push off over your big toe, the foot becomes a rigid lever to propel the body in a forward direction, and the plantar fascia releases stored energy, driving you forward.
Put simply; we have a spring under our foot assisting us to move efficiently every step, taking the strain off our leg muscles to allow us to walk and run.
Plantar fasciitis is a condition that occurs over time when the load on the foot exceeds the strength of the plantar fascia and surrounding muscles, causing the plantar fascia to become irritated.
If left undiagnosed or untreated, Plantar fasciitis can develop into a Heel spur, a calcium deposit where the fascia tissue band connects to the heel bone. While the heel spur itself is not typically a cause of pain, it is an indication of long standing high load or strain on the plantar fascia.
Additional conditions that cause heel pain include Achilles tendinitis, irritation of the tendon that connects your calf muscle and heel bone, stress fractures of the heel bone, or stone bruising to the fat pad of the heel. Heel pain can also be caused by nerves around the heel becoming trapped around joints or within muscles. Correctly identifying heel pain is paramount for effective treatment.