Plantar fasciitis is a very common foot problem. It usually starts as an occasional dull pain under the heel and can progress to a sharp, persistent pain.

The plantar fascia is like a thick ‘elastic’ band under the the foot. It attaches the heel bone to the bases of the toes. When the arch of the foot lowers, tension through the band increases, pulling on the attachments. Each step we take pulls on the attachments, prolonging the problem.

People with heel pain should book a New Patient Musculoskeletal appointment.

Pain under the heel that can radiate to other areas of the heel and the midfoot. Pain is frequently felt when standing and starting to walk and then eases off after a short period of time. Every step we take puts tension on the plantar fascia, meaning the problem worsens with activity and lack of specialised support.

Repetitive impact at the attachment of the plantar fascia can cause tears and inflammation. This may be caused by a one off trauma, but is frequently caused by increased or altered activity and lack of appropriate support.

The Achilles tendon runs down the back of the lower leg connecting the calf muscle to the heel bone. The muscle and tendon work to lift the heel off the ground when walking.

Achilles tendonitis is an inflammation of the Achilles tendon., which is usually short lived. However, the tendon can lose its structure and develop microscopic tears, where it attaches to the heel bone. In rare cases, chronic degeneration with or without pain may result in rupture of the tendon.

People with heel pain should book a New Patient Musculoskeletal appointment.

Pain within the tendon, frequently felt in the narrow area above the heel, up towards the base of the calf muscle. Pain is commonly felt on initial weight bearing or after periods of rest, then improves somewhat with motion but later worsens with increased activity.

Tenderness, or sometimes intense pain, when the sides of the tendon are squeezed. There is less tenderness, however, when pressing directly on the back of the tendon.

When chronic, the tendon may become enlarged and may develop nodules in the area of tissue damage.

Achilles tendonitis is usually caused by a sudden increase of a repetitive activity. Such activity puts too much stress on the tendon too quickly, leading to micro-injury of the tendon fibres. Ongoing stress on the tendon, even when just walking, makes it difficult for the the body to repair the injured tissue, resulting in continuous pain.

Athletes are at high risk of developing Achilles tendon disorders, as are people whose work or weekend activities puts stress on their ankles and feet. People with ‘flat feet’ place greater demands on the tendon when walking.

Children experiencing growth spurts can experience pain in the heels, as the calf muscles pull on the tendons.

Although Plantar Fasciitis and Achilles injuries are some of the most common causes of heel pain, these are not the only heel disorders people experience.

Similar to Carpal Tunnel in the wrist, people with pain around the ankle joint on the inside leg, may be suffering from Tarsal Tunnel syndrome. Caused by pressure from swelling and inflammation in this region, pressure is applied to the nerves causing pain.

Localised swelling may be caused by trauma such as tripping or falling, or may be due to the heel rolling in and flatter foot arches.

Heel spurs under or behind the heel are bony deposits caused by calcification. Some people may not experience any symptoms, others may have significant pain.

For people with non healing plantar fasciitis, this may be a causal factor. Although removal of the spurs requires surgery, appropriate insoles can reduce symptoms so that patients no longer experience pain.