Healing A Hurt Heel

For the second article in our new series on sports injuries, a sports medicine physician takes us through the causes and treatments for plantar fasciitis, commonly experienced as pain in the heel.

- Dr Au Yong Pui San

The plantar fascia is a thick fibrous band of tissue that stretches from the inner underside of the heel bone to the base of the toes. It provides support to the arch of the foot.

When there is too much stress to the plantar fascia, it can become inflamed, thickened and swollen, causing pain on the heel or along the arch of the foot. This condition is called plantar fasciitis (pronounced fash-ee-ai-tis).

The condition is commonly associated with overuse and usually occurs slowly. Typically, the usual complaint will be pain at the heel, especially upon waking up in the morning and taking the first step out of bed. Similarly, there will be pain in the heel during the first step after a period of prolonged immobilization (for eg, sitting in a car for a long journey or after a movie marathon).

Early in this condition, the pain eases after walking around but if it is left untreated, the pain worsens and lingers throughout the day.

WHAT CAUSES IT?

Some people are more prone to developing this condition, such as those with high body mass index, are flat footed, have overpronation of the feet and very tight calves (typical of people who do not stretch on a regular basis and people who love wearing high heels).

In the more athletic population, especially runners, common predisposing factors that may lead to the road of prolonged pain and (most times debilitating) discomfort of plantar fasciitis are:

1 Poor running biomechanics (or running form), where there is over pronation of feet and/or too much heel strike during running gait. This places a lot of stress onto the plantar fascia leading to irritation and inflammation.