Plantar fasciitis & Plantar Heel Pain
Heel pain can be frustrating and limiting, particularly when it affects walking, running, work or everyday activities.
Plantar fasciitis is one of the most common causes of pain underneath the heel. It typically causes pain around the centre or inner part of the heel on the underside of the foot, which can sometimes extend towards the arch.
Pain is often particularly noticeable with the first few steps in the morning or after sitting for a period of time. However, not all heel pain is caused by plantar fasciitis.
At MK Orthotics in Milton Keynes, we assess the way your feet and lower limbs function during walking and running to help identify factors that may be contributing to your symptoms. Where appropriate, orthotics may form part of an individual treatment plan.
What is plantar fasciitis?
Despite its name, plantar fasciitis is not necessarily an inflammatory condition.
The plantar fascia is a strong band of connective tissue that runs along the underside of the foot, helping to support the foot and transmit forces during standing and walking.
Plantar heel pain is thought to be related to the way the plantar fascia and surrounding tissues are loaded rather than simply being the result of inflammation.
The exact cause can vary from person to person. Factors such as changes in activity, the way the foot functions, reduced joint or muscle flexibility and increased loading through the foot may all be relevant.
What does plantar fasciitis feel like?
Typical symptoms can include:
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Sharp or aching pain underneath the heel
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Pain that may extend into the arch
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Pain with the first few steps after getting out of bed
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Pain after sitting or resting for a period of time
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Pain that increases with prolonged standing or walking
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Symptoms associated with increased activity, running or changes in training
The pattern of symptoms can vary, which is why a proper assessment is important rather than assuming that every episode of heel pain is plantar fasciitis.
Is all heel pain plantar fasciitis?
No.
Several other conditions can cause pain underneath or around the heel and may produce symptoms that are similar to plantar fasciitis.
These can include:
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Nerve entrapment, including Baxter's nerve entrapment
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Tarsal tunnel syndrome
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Fat pad problems
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Stress injury or stress fracture
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Plantar fascia injury or rupture
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Referred pain from the lower back
Some of these conditions require a different approach to treatment, so identifying the likely source of the pain is an important part of the assessment.
If your heel pain doesn't follow the typical pattern of plantar fasciitis, or if it has persisted despite treatment, it may be particularly important to consider other possible causes.
Could the way I walk or run be contributing to my heel pain?
Potentially.
The foot and lower limb work as a connected system during walking and running. The way the foot moves, how forces are distributed through the foot and lower limb, joint movement and muscle function can all influence the loads placed on different tissues.
This doesn't mean that there is one particular "correct" foot position or that everyone with a certain foot shape needs an orthotic.
At MK Orthotics, we look at how your feet and lower limbs function, rather than simply deciding that a particular foot posture needs correcting.
Can Orthotics help plantar fasciitis?
Orthotics can be useful for some people with plantar heel pain, but they are not automatically the right treatment for everyone.
An orthotic may be considered where the assessment suggests that altering the way forces are distributed through the foot could help reduce stress on overloaded tissues.
The design of an orthotic should therefore be based on the individual rather than simply prescribing the same type of arch support to everyone with heel pain.
Your footwear, activity levels, symptoms, foot mechanics and the way your lower limb functions can all be relevant when deciding whether an orthotic is appropriate.
The aim isn't simply to put an arch support underneath your foot. The aim is to understand what may be contributing to your symptoms and decide whether an orthotic could form part of the solution.
What happens during an assessment at MK Orthotics?
Your initial appointment lasts approximately 90 minutes and includes a detailed assessment and video gait analysis.
We look at how your feet and lower limbs function during movement and consider how this relates to your symptoms.
Depending on your individual presentation, the assessment may consider:
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Your symptoms and activity levels
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Foot posture and movement
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Joint range of movement
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Muscle function
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Lower-limb alignment
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Walking and/or running mechanics
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Footwear
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Previous injuries
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Previous orthotics or insoles
Video gait analysis can help identify features of your walking or running pattern that may be relevant to your symptoms.
If orthotics are appropriate, individually made foot orthoses can be designed to help reduce stress on overloaded joints and muscles.
What if I've already tried arch supports or orthotics and they didn't work?
This is something we see regularly.
If you have previously bought or been prescribed orthotics or arch support insoles and they haven't helped, bring them with you to your assessment.
Looking at your existing arch support/ orthotics devices can provide useful information about what has previously been tried and whether there may be a reason they haven't worked for you.
Sometimes restrictions in normal joint movement, muscle tightness or other aspects of foot and lower-limb mechanics may need to be considered rather than simply changing the orthotic.
Depending on your assessment, other approaches such as foot mobilisation techniques or Kinesio taping may also be considered as an adjunct or alternative to orthotic treatment.
Do I need custom orthotics?
Not necessarily.
An assessment may show that orthotics are appropriate, but it may also identify other factors that should be addressed first.
At MK Orthotics, the aim is to understand the individual problem and consider the most appropriate treatment rather than assuming that everyone with foot pain needs a bespoke orthotic.
Where orthotics are appropriate, bespoke foot orthotics or off the shelf orthotics are prescribed following assessment.
When should I have heel pain assessed?
Consider seeking professional assessment if:
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Your heel pain is persistent or worsening
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It is limiting your walking, work, exercise or running
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You have tried changing your activity or footwear without improvement
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Your symptoms don't follow the usual pattern of plantar fasciitis
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You have significant swelling, bruising or difficulty bearing weight
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You have numbness, tingling or burning sensations
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You have previously tried orthotics without success
Persistent or unusual heel pain may have a cause other than plantar fasciitis and may require a different form of investigation or treatment.
Related Foot and Ankle Conditions
Heel pain can have a number of possible causes. You may also find the following information useful:
Baxter's Nerve Entrapment
Heel pain caused by irritation or compression of a nerve can sometimes be mistaken for plantar fasciitis.
Tarsal Tunnel Syndrome
Nerve compression around the inside of the ankle can cause burning, tingling, shooting pain or numbness in the heel and sole of the foot.
Flat Feet
Foot posture and lower-limb mechanics may be relevant to some people's symptoms, although having flat feet does not necessarily mean that treatment is required.
Achilles Tendinopathy
Pain around the back of the heel has a different pattern and may require a different assessment and treatment approach.
Why choose MK Orthotics?
At MK Orthotics, we don't simply look at the painful area in isolation.
The aim is to understand why you may be experiencing pain and what factors could be contributing to it.
Your assessment is carried out by Sharon Holroyd BSc (Hons) P&O, MBAPO, HCPC Registered, a qualified Prosthetist & Orthotist with experience across NHS orthotic services and a specialist interest in gait analysis, biomechanics, sports injuries and common foot conditions.
Patients have described the assessment as thorough and have highlighted Sharon's approach of listening carefully and considering the most appropriate solution rather than rushing to treatment.
Foot pain affecting your everyday life?
You don't need to know exactly what is causing your heel pain before contacting us.
A detailed biomechanical assessment can help establish what may be contributing to your symptoms and whether orthotics are appropriate for you.
MK Orthotics is based in Blakelands, Milton Keynes.
Book an assessment
Initial assessment with video gait analysis — 90 minutes.
If you have previously used orthotics, bring them with you to your appointment so we can assess what you've been using and consider why they may not have worked for you.