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Plantar Heel Pain

Plantar fasciopathy: is a generalised blanket term used to describe a long term overuse problem of the plantar fascia that causes heel pain. Plantar fasciopathy includes the two phases of damage which are the inflammatory phase (plantar fasciitis) and the non inflammatory phase (plantar fasciopathy).

Plantar fasciitis: is the term used to describe heel pain caused by the inflammation of the plantar fasciia and usually consists of intense pain, heat and swelling of the area in the days after the damage has occurred. This phase often lasts only several days unless the plantar fascia is repetitively being damaged by over use. A good indicator that the heel is inflamed is if there is pain at the end of the day in the  area of insertion of the plantar fascia.

Plantar fasciosis: is the term used to describe heel pain caused by the degeneration (deterioration) of the plantar fascia which often occurs as a result of repetitive stress. This pain is more likely to be ongoing with little changes in the pattern of pain from day to day. This pain is more likely to occur after rest or after sitting etc. Due to the deterioration in strength of the plantar fascia over time, the plantar fasciia becomes easier to damage, more prone to becoming re-inflammed (plantar fasciitis), and thus people often end up going through cycles of inflammation. Inflammation leads to degeneration, degeneration increases risk of inflammation, and so on...

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Who gets Heel Pain?

 

The greatest incidence of heel pain is seen in middle-aged men and women. It is also seen in those who take part in regular activities and those significantly overweight and on their feet  a lot. Heel pain can also occur in children, usually between 8-13 as they become increasingly active in sporting activities. 

 

The causes of Plantar Heel Pain?

 

Causes are many but it can be as a result of standing or walking on hard floors all day. Running and jogging can contribute to it. Footwear plays an important role  togather with age, sex, BMI and medical conditions. As a result pain can occur due to calcanues (heel bone) bone marrow oedema, stress fracture with the body of the bone or heel spur, Nerve intrapment, intrinsic soft tissue inflammation including plantarfascia and other systemic inflammatory disorders.

 

Other causes of Heel Pain

 

  • Excessive rolling in (pronation - over-pronation) of the feet when walking

  • An inflamed bursa (bursitis), a small, irritated sack of fluid at the back of the heel

  • A neuroma (a nerve growth)​

  • Achilies tendon inflammation/partial tear​

  • Heel bumps; a bony enlargement at the back of the hell bone​

  • Sever's disease (Kids aged 8-13 approx)​

  • Referred pain (nerve entrapment)

  • Bruise or stress fracture to the heel bone

  • Other soft tissue growths (callouses, corns, warts, or combination)​

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