Pain at the back and bottom of the foot can be a few different pathologies.
Often, management plans are similar because the soft tissue at the back of the foot works closely together to help walking.
Plantar Fasciitis and Achilles Tendinopathy are two very common conditions that occur at the back of the heel.
There may be other pains present in this region however, such as impinged nerves, bursitis, ankle ligament tears, corns and callous, foreign bodies and deeper foot muscle strains.
Plantar Fasciitis
Plantar Fasciitis occurs when the fascia (a thick band of connective tissue) becomes strained.
The Plantar fascia extends from the front of the heel to the toes, and mainly to the big toe.
The Plantar fascia's job is to support the arch when it flattens during walking, and enable the big toe to push off the ground.
TIP: You can sometimes feel your Plantar fascia if you extend your big toe and press along your arch- it feels like a tight band.
Achilles Tendinopathy
The Achilles Tendon begins at the bottom of the calf as it connects to the big calf muscles that you can feel at the back of your leg. The tendon attaches to the bone (calcaneus) on the sides and slightly on the bottom of the heel.
The job of the Achilles tendon is to transmit the energy from the rest of the body when walking through to the foot (and Plantar Fascia) to enable walking.
EXTRA INFO: The Achilles tendon is the biggest tendon in the body and is vital for a normal walking gait.
IS IT PLANTAR FASCIITIS OR ACHILLES TENDINOPATHY?
Great question!
The back of the heel is Achilles territory. Therefore, pain here is usually Achilles Tendinopathy.
Pain under the arch or at the front of the heel is usually Plantar Fasciitis.
It is common to have a bit of both! Usually, if both places are sore it means that the pain has been there for a while and the body has attempted to compensate and has become damaged in the neighbouring tissue structure. Muscles, tendons and ligaments that do similar functions or are in a similar region often compensate for each other therefore are more likely to be damaged by chronic pain.
But you're really asking... HOW DO WE TREAT PLANTAR FASCIITIS AND ACHILLES TENDINOPATHY?
ANSWER: In essentials, a very similar way.
We check:
Footwear is supportive
Hard heel counter (at the back of the heel)
Heel height is slightly higher than the front of the shoe
The outer sole is firm and not able to be "wrung out to dry" or bent like a banana.
Shoes are not too old
Foot position
Does the person need more support than they are getting from good quality shoes?
The Achilles tendon and Plantar Fascia work best when the foot moves in an optimal way. Suboptimal foot position when walking causes additional strain on these regions and can often be a cause, or majorly contributing to pain.
Orthotics and good shoes are a long- term solution to foot pain for most people
Strength
Careful and targeted strengthening is vital for rehabilitation of tendons and fascia.
Strength allows the body to respond to the load of walking better and reduces the chances of strain to the tissues and pain.
The Achilles Tendon particularly, responds very well to strengthening
Strengthening the Calf muscles and large foot and leg muscles is essential in rehabilitation for rearfoot pain.
Stretching
Stretching gently in the calves and bottom of the foot yields great results when coupled with strengthening. The muscles should be long and strong for optimal rehabilitation.
Activity
We check your activity to make sure you are not completing any tasks that are too much for your foot and ankle and may be contributing to your pain. For Achilles Tendinopathy and Plantar Fasciitis, continuation of activity and general strength is important, however it is easy to overdo activity and result in a return of pain.
Onset of Pain
Chronic and Acute pain is treated in slightly different ways with the modalities we use at Foot Body Sole. We do a full assessment to ensure we choose the correct treatment option for your type and duration of pain.
You may be asking, How do I help myself at home?... There are heaps of ways!!
Apply cold therapy/ice pack wrapped in a tea towel when your foot is very sore.
Rest from your current activity when it causes additional pain
Consider a gentle Compression Sleeve or OS1st support sock from our clinic which provides some assistance both with support and swelling reduction.
Check your shoes for the features noted above
Begin some gentle movement with your feet and a Theraband/Rocco Band to build the Range of Motion in your joints and soft tissues, and provide a slight stretch and strengthening force to the region.
Massage the sore region with your hands and some Fisiocrem, or a Spiky Ball on the bottom of your feet.
Grab some Heel Lifts and pop them in your best runners to give your feet a break while they recover.
Begin some calf strengthening: stand on your tippy toes and hold that position for around 20 seconds. Repeat for 3-4 repetitions if there is low- no pain in your injury location.
If your pain persists or you want to rehabilitate quicker and more effectively, let us know at Foot Body Sole, we love to help with Plantar Fasciitis or Achilles Tendinopathy.
We offer Electrotherapy in the form of Laser therapy (Low Level and High Powered), Therapeutic Ultrasound, Radial Shockwave therapy and Interferential (TENS) therapy.
We also are practiced in Dry Needling, Cupping, taping and padding, Prolotherapy, massage and individual assessment and rehabilitation plans and advice.
We can prescribe Over the Counter, Semi- custom and Custom orthotics/Insoles, and can send for bulk billed X-ray and Ultrasound.
Give us a call, come in- store or send us an email at Foot Body Sole
108 Bridport st Albert Park
(03) 8648 7678
info@footbodysole.com.au
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