Plantar heel pain (a.k.a plantar fasciitis)

 

Pain underneath the heel is the most common thing our patients present with at The Biomechanics Lab.

 

And the thing that every patient thinks is the problem is the dreaded 'plantar fasciitis". Technically, based on the research, this condition is not inflammatory. When you use medical imaging, you often see swelling of the plantar fascia, small tears in the fascia, bone swelling (oedema). In more complex cases you can also see irritation or entrapment of nerves, muscle swelling, fat pad degeneration and bone pathology.

The take home? The condition is more complex that just being labelled plantar fasciitis. It needs to be assessed by a podiatrist with extensive experience, and treatment can't be started until you have a diagnosis.

 

What is the cause of plantar heel pain?

Research suggests 1 in 10 people will suffer from plantar heel pain in their life. Despite how common it is, we still don't know exactlly what causes the pain. Sudden weight increase, higher body mass, and large increases in physical activity are known to be associated with the pain, but they aren't always the cause.

Our approach is that pain presents when the force applied to the heel (causing compression) that is more than the heel can handle. This may purely be the amount of force, but also the way the foot moves when the force is applied (which can cause tension in plantar soft tissue). 

 

So how do we treat plantar heel pain at The Biomechanics Lab?

  • We make a diagnosis. In our experience, only 60-70% of the time is the plantar fascia actually the problem. Given nerve, bone and muscle can also cause pain inthe plantar heel, it is important to get the diagnosis right so we can prescribe the most approrpiate treatment. To often we see patients prescribed a recipe of treatment without an actual diagnosis being made. Sometimes imaging is required to confirm exactly what the problem is.

 

  • We identify the cause of your pain. It is not good enough to just relieve symptoms. We get to the cause of the problem and address that to ensure your problem does not return. Using force platform technology, we can measure the forces applied to your heel when you walk. This allows us to design treatments to directly influence the force causing the problem.

 

  • We educate you so that you understand your problem. What likely caused it, what you can and can't do, and how long it may take to get better. Only once you understand the whole situation are you empowered to make change for the better.

 

  • We design a comprehensive management plan, that focuses on both: 
    • Immediate symptom relief. This is the focus for the first 4 weeks and focuses on how forces can be moved away from symptomatic structures to allow them to heal. The question we ask is "how can we get you more comfortable as quickly as possible"?
    • Long-term positive outcome. We look to build capacity of your bones, muscles, ligaments and tendons to build strength, condiitoning and resilience. We focus on control of movement, biomechanics, lifestyle factors that can be modified to improve long-term prognosis.

 

  • We monitor outcomes. Just because you may not be in the clinic, doesn't mean we aren't thinknig about you. We are driven by continued improvement, and will stay in touch to ensure you are tracking in the right direction.

 

At The Biomechanics Lab, we have extensive experience in treating plantar heel pain.

We have not just treated 1000's of patients, but also researched widely on how best to manage the condition (you can read the findings of my PhD here).

 

If you are experiencing plantar heel pain and would like to discuss how best to manage it with us, then click below and make an appointment:

 

Book an assessment of your plantar heel pain 

 

Dr Chris Bishop (PhD)
Director | The Biomechanics Lab

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