Heel Pain
Plantar Fasciitis

• Pain experienced under the heel and/or along the arch of the foot
  
• Pain that is worse with the first steps in the morning and after prolonged sitting
  
• Dull intermittent pain which can progress to sharp persistent pain
  
• General stiffness felt in foot/ankle
  

• An inflammation of the connective tissue of the bottom of the foot
  
• Plantar= bottom of the foot, Fascia= dense fibrous connective tissue, Itis = inflammation
  
• The plantar fascia attaches to the bottom of the heel bone and fans out to the toes
  
• The plantar fascia is designed to support the foot and form teh arch. It has very little elasticity and is very thick
  

• A heel spur is an abnormal growdth of bone on the heel due to excessive stress of pulling where the plantar fascia attaches to the heel
  
• The excessive tugging of the plantar fascia on the heel bone causes this excess of bone (bone spur) to grow in a pointed fashion
  

• Pronation is a normal movement of the foot that helps the body to absorb shock and adapt to different ground surfaces.
  
• In analyzing ones gait, first contact is on the heel and outside of the foot; followed by a shift of the body weight continuing forward, toward the arch and toes.
  
• If the foot is weak or tired and/or the footwear is not supportive, then the arch can flatten more than normal, which is excessive pronation.
  
• Flattening of the arch (excessive pronation) places pressure on the arch and stretches the plantar fascia (which supports the arch) and can create imflammation at the attachment on the heel
  
• This repetitive, excessive pronation is the main contributor to many lower extremity, overuse injuries, of which plantar fasciitis and heel spurs are the most common in the foot
  

• Age - With increasing age, often there is decreasing flexibility
  
• Any sudden change in activity, specifically activities that increase weight bearing or pressure on the foot
  
• Changes in training - Increased toe runing, speed of running or hill running can add stress to the feet
  
• Flat, pronated feet or rigid, high arched feet may be more prone to problems
  
• Sudden increase in body weight (such as pregnancy) may also add strain
  
• Poor support in the shoes being worn and/or the poor support inside the shoes can add to the stress on the foot
  
• Biomechanical changes in the foot can cause increases in pronation (see Primary Causes)
  

• Stretching of the calf, Achilles tendon and foot can help or emiminate the majority of plantar fasciitis problems
  
• Strengthening the muscles of the foot and ankle can assist in eliminating and avoiding these problems
  
• Supporting the foot with proper shoes and insoles, can prevent or help to eliminate the vast majority of foot related problems. This may be a Birkenstock sandel, with a broad base and contoured footbed, that is low to the ground and conforming to the foot. It may be a shoe with an upper that wraps the foot and supports the arch and heel, thus limiting excessive pronation. The vast majority of footwear have more than enough cushion but very little support for the arch and heel. One of the easiest and most effective solutions is to add a simple heal over the counter insole that provides a forgiving support for both the arch and the heel.
  
• If you refer to Heel spurs.com you can see the results of 1300 respondents. Arch supports are recognized as the most successful remedy with stretching a close second