Affecting up to 15% of the population, (primarily in the 40-75 age group), Plantar Fasciitis used to be known as Plantar Heel Spur Syndrome. It is now generally accepted that Plantar Heel Spurs (as seen on X-Ray) are generally NOT a cause of pain (studies show that around 30% of the population in the 40-70 age group have asymptomatic Plantar Heel Spurs). The actual cause of the pain, (which is often in exactly the same area as the spur) is the damaged/torn Plantar Fascial attachments - at their insertions into the Calcaneus/heel bone -(evident under Ultrasound as a thickened Plantar Fascia).
As previously mentioned, the Plantar Fascia is a long, wide band of fibrous, connective tissue that runs nearly the entire length of the bottom of the foot. Its function is to support, strengthen and reinforce the foot and the arch, and to provide shock absorption.
Excessive and repetitive strain on the Plantar Fascia can cause micro-tearing or actual tears to occur in the heel/arch area, leading to inflammation and pain. This initial acute (inflammatory) form of Plantar Fasciitis, can then develop into a more chronic (degenerative) form if it doesn't resolve within a period of approximately 3 months. Fortunately, more than half of acute cases will settle and resolve within this time period, however, those that don't and then become chronic cases often require much more comprehensive and tailored treatment to overcome them. This may require several months for full healing and pain relief to occur.
The pain of Plantar Fasciitis is often only experienced first thing out of bed in the morning, and/or upon rising after a prolonged period of rest ("start-up pain"). This can quickly progress, however, to a more constant pain throughout the day, particularly during and/or after long periods on one’s feet. The level of pain experienced by sufferers can also vary greatly from case to case, (depending on the nature and extent of the damage to the fibres that make up the Plantar Fascia) - from mild discomfort, through to debilitating, relentless pain.
The excessive strain which brings about Plantar Fasciitis can be caused by a repetitive, overuse type of movement, (eg: prolonged periods of standing, walking, running) OR it may be brought about by one specific incident (eg: landing heavily or awkwardly on your foot/feet).
Tension on the Plantar Fascia may also be greatly increased by a myriad of environmental, biomechanical, and other factors. Hard, flat, modern-day surfaces, certain activities such as running and jumping, extended periods on one’s feet, inadequate footwear, tight calves, inefficient foot and lower limb biomechanics (mainly overpronation - a foot that rolls inwards too much) are all leading contributing factors. In fact, research and studies show that the vast majority of long-term/chronic Plantar Fasciitis sufferers have inefficient foot structures/lower limb biomechanics, which are simply unable to cope with the demands of weight-bearing on hard, flat, modern-day surfaces, such as concrete, tiles, and asphalt.
Plantar Fasciitis induced by a repetitive strain (ie: simply by the action of too much standing, walking or running for example) is by far more prevalent, harder to resolve, and much more likely to become chronic/degenerative/longstanding than Plantar Fasciitis which has been caused by a specific incident/injury. When you first acquire the symptoms of Plantar Fasciitis, there is no way of really knowing how long you will have it for. Research has shown that the longer you endure it for, or defer treatment, the longer it can take to resolve.
Our tailored treatment plans (whether for acute or chronic Plantar Fasciitis), are based on our 3 fundamental principles to heal your heel (Plantar Fascia):
A combination of all three will give the best chance of complete healing and staying permanently pain free.
With Heal My Heel you can do just that!
PLEASE NOTE: For Heel Bursitis, Retrocalcaneal Spurs, and Haglund's Deformity go to "Other Heel Pain Pathologies" below.
The Achilles Tendon serves as the attachment or anchor point for the calf muscles. The tendon attaches in a fan-like manner around the back of the Calcaneus (heel bone). The Achilles Tendon/Calf Muscle complex is a very powerful one, and provides strong propulsion during gait (among other things).
Excessive strain on the Achilles, (both longitudinal and torsional/twisting), can cause micro-tearing or actual tears to occur (either in the mid-portion of the tendon just above the heel, or at the insertional attachments at the back of the heel/Calcaneus). These specific areas of pain and tissue damage in different locations in the tendon are classified as:
The excessive strain on the tendon could be brought about by a repetitive type action (eg: standing, walking, running, jumping- in some cases termed an overuse injury), or from a single specific incident/injury (eg: sudden acceleration from stationary to sprinting) and both are exacerbated by the following environmental and biomechanical factors:
Achilles Tendon damage caused by an overuse or repetitive strain (rather than a specific incident/injury) is far more prevalent, harder to resolve, and much more likely to become chronic/degenerative/longstanding. This chronic, degenerative process usually sets in after acute Achilles Tendonitis (insertional or mid-portion) has been present for approximately 3 months. This degeneration of the affected Achilles Tendon fibres (which can be exacerbated by acute "flare-ups" - inflammation - in the exact same spot) often causes significant pain, and can also severely impair the healing response in the damaged tissue. Consequently, longstanding, painful cases lasting several months or even years are not uncommon.
Our tailored treatment plans, (whether for acute or chronic Achilles Tendon issues), are based on our 3 fundamental principles to heal your heel (Achilles Tendon):
A combination of all 3 will give the best chance of complete healing and staying permanently pain free.
With Heal My Heel you can do just that!
Also known as Calcaneal Apophysitis, Severs Disease affects about 15% of children in the 7 - 15 age group. The growth plate inside the heel bone/Calcaneus is responsible for the bone's growth and development. The Calcaneus fully matures and stops growing at an average age of 12 in girls, and boys at around 14.
Sever's is triggered by a kind of disruption to the growth plate which is exacerbated by certain activities, (running and jumping in particular). The consequent inflammation and pain is often not experienced until well after the commencement of the activity (up to an hour), and often then lasts for some time after its completion before settling down (minutes to days). It can also become significantly more painful once the activity is completed and the area "cools down". The stress of the Achilles Tendon pulling and twisting on the back of the heel bone during certain weightbearing activities (especially running/jumping) is responsible for the irritation and inflammation of the growth plate inside the bone.
The pain associated with Sever's can often be linked to periods of accelerated growth ("growth spurts"), and therefore pain is often felt intermittently over the period of development of the Calcaneus bone (several years).
Other contributing factors are hard, flat surfaces (this includes very firm grass surfaces), inadequate footwear, tight calves, and inefficient foot structures/lower limb biomechanics (mainly over-pronation - a foot that rolls inwards too much). In fact, research and studies show that the vast majority of children that suffer from the pain of Sever's Disease have inefficient foot structures/lower limb biomechanics. Treatment for Sever's is really a case of managing the pain rather than "healing" it as such. That is because it is essentially a "growing pain" which inevitably must run its course. The symptoms of Sever's can last anywhere from days to several years (although usually intermittent if for this long a period). The pain associated with Sever's, however, (even if debilitating), can be significantly reduced if the underlying causes are first identified, and then effectively targeted.
Heal My Heel's management of Sever's Disease is based on our 3 fundamental principles for treatment:
This will give the best chance of reducing the pain and inflammation as much as possible, while still allowing the sufferer to participate in sporting activities.
With Heal My Heel you can do just that!
