Don't let heel pain keep you from exercising
Heel pain is a common foot problem, with pain occurring under the heel or just behind it, where the Achilles tendon connects to the heel bone. Although heel pain makes walking difficult, daily walking is actually one of the best therapies.1
Did you know?
Diagnosis and testing
What increases your risk2?
High arched foot
Reduced ankle dorsiflexion (less able to raise the foot towards the shin, usually due to shortened Achilles tendon)
What can we do about it
Stretching exercise for plantar fasciitis:
To stretch the plantar fascia, use one hand to gently pull toes up toward the shin while the other hand is placed under the foot to check that the plantar fascia is pulled tight. This position should be held for 30 seconds and repeated at least three times daily.28
Approximately four out of five patients with plantar fasciitis will improve without surgery within 12 months.17
Non-surgical treatments include rest, ice massage, anti-inflammatory medications, taping, stretching and strengthening, supportive shoes and heel cups, and activity modification.
The American Orthopaedic Foot and Ankle Society recommends using non-surgical treatments for at least six months before considering surgery for plantar fasciitis. Non-surgical treatments have a much higher success rate, without the risk of post-surgical complications.18
To reduce the pain of plantar fasciitis, try these self-care tips:
The vast majority of patients with plantar fasciitis will improve with conservative therapies alone. Weight loss, activity modification, stretching and strengthening exercises, supportive shoes and ice massage may provide relief and healing.
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3. Riddle DL, Schappert SM. Volume of ambulatory care visits and patterns of care for patients diagnosed with plantar fasciitis: a national study of medical doctors. Foot Ankle Int. 2004;25(5):303-10. doi:10.1177/107110070402500505
4. Taunton JE, Ryan MB, Clement DB, McKenzie DC, Lloyd-Smith DR, Zumbo BD. A retrospective case-control analysis of 2002 running injuries. Br J Sports Med. 2002;36(2):95-101. doi:10.1136/bjsm.36.2.95
5. Sadat-Ali M. Plantar Fasciitis/Calcaneal Spur among Security Forces Personnel. Military Medicine. 1998;163(1):56-7. doi:10.1093/milmed/163.1.56
6. Hill CL, Gill TK, Menz HB, Taylor AW. Prevalence and correlates of foot pain in a population-based study: the North West Adelaide health study. J Foot Ankle Res. 2008;1(1):2. doi:10.1186/1757-1146-1-2
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9. Van Leeuwen KDB, Rogers J, Winzenberg T, Van Middelkoop M. Higher body mass index is associated with plantar fasciopathy/'plantar fasciitis': Systematic review and meta-analysis of various clinical and imaging risk factors. 2016.
10. Hotta T, Nishiguchi S, Fukutani N, Tashiro Y, Adachi D, Morino S, et al. The association between plantar heel pain and running surfaces in competitive long-distance male runners. Journal of Sports Medicine and Physical Fitness. 2016.
11. Waclawski ER, Beach J, Milne A, Yacyshyn E, Dryden DM. Systematic review: Plantar fasciitis and prolonged weight bearing. 2015.
12. Oloff LM, Schulhofer SD. Flexor hallucis longus dysfunction. J Foot Ankle Surg. 1998;37(2):101-9. doi:10.1016/s1067-2516(98)80088-4
13. Labovitz JM, Yu J, Kim C. The role of hamstring tightness in plantar fasciitis. Foot Ankle Spec. 2011;4(3):141-4. doi:10.1177/1938640010397341
14. Mahmood S, Huffman LK, Harris JG. Limb-length discrepancy as a cause of plantar fasciitis. J Am Podiatr Med Assoc. 2010;100(6):452-5. doi:10.7547/1000452
15. Werner RA, Gell N, Hartigan A, Wiggerman N, Keyserling WM. Risk factors for plantar fasciitis among assembly plant workers. PM R. 2010;2(2):110-6; quiz 1 p following 67. doi:10.1016/j.pmrj.2009.11.012
16. Schneider HP, Baca JM, Carpenter BB, Dayton PD, Fleischer AE, Sachs BD. American College of Foot and Ankle Surgeons Clinical Consensus Statement: Diagnosis and Treatment of Adult Acquired Infracalcaneal Heel Pain. 2018.
17. Buchbinder R. Clinical practice. Plantar fasciitis. 2004.
18. American Orthopaedic F, Ankle S. Don’t perform surgery for plantar fasciitis before trying six months of non-operative care. 2014.
19. Crawford F, Thomson CE. WITHDRAWN. Interventions for treating plantar heel pain. Cochrane Database Syst Rev. 2010(1):CD000416. doi:10.1002/14651858.CD000416.pub2
20. Muth CC. Plantar fasciitis. 2017.
21. Najjar RS, Feresin RG. Plant-Based Diets in the Reduction of Body Fat: Physiological Effects and Biochemical Insights. Nutrients. 2019;11(11). doi:10.3390/nu11112712
22. Towery P, Guffey JS, Doerflein C, Stroup K, Saucedo S, Taylor J. Chronic musculoskeletal pain and function improve with a plant-based diet. Complement Ther Med. 2018;40:64-9. doi:10.1016/j.ctim.2018.08.001
23. Lim AT, How CH, Tan B. Management of plantar fasciitis in the outpatient setting. Singapore Med J. 2016;57(4):168-71. doi:10.11622/smedj.2016069
24. Landorf KB, Menz HB. Plantar heel pain and fasciitis. 2008.
25. Sweeting D, Parish B, Hooper L, Chester R. The effectiveness of manual stretching in the treatment of plantar heel pain: A systematic review. 2011.
26. Martin RL, Davenport TE, Reischl SF, McPoil TG, Matheson JW, Wukich DK, et al. Heel pain-plantar fasciitis: revision 2014. J Orthop Sports Phys Ther. 2014;44(11):A1-33. doi:10.2519/jospt.2014.0303
27. Pfeffer G, Bacchetti P, Deland J, Lewis A, Anderson R, Davis W, et al. Comparison of custom and prefabricated orthoses in the initial treatment of proximal plantar fasciitis. Foot Ankle Int. 1999;20(4):214-21. doi:10.1177/107110079902000402
28. Sheon RP, Buchbinder R. Plantar fasciitis and other causes of heel and sole pain2011 May 5, 2020. Available from: https://somepomed.org/articulos/contents/mobipreview.htm?13/49/14097.
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