Why do I experience heel pain while taking my first few steps in the morning?
If you are experiencing heel pain upon initial weight-bearing in the morning, you may be experiencing a condition called plantar fasciitis. The plantar fascia is a layer of tissue that originates from the heel to the forefoot. It acts as a dynamic stabilizer of the medial longitudinal arch of the foot while walking and running.
Since the plantar fascia reinforces the medial arch of the foot and assists with propulsion of the foot, plantar fasciitis is prevalent in runners and athletes involved in sports, such as basketball, gymnastics and soccer. Plantar fasciitis is an inflammatory process and can present with the following signs and symptoms:
- Pain and tenderness of the medial aspect of the heel, especially upon initial weight bearing in the morning
- Mild swelling of the region may be present
- The heel pain may feel better as the day progresses, but it may worsen as the activity level increases (running, stair negotiation) and after an extended period of inactivity (sitting at a desk)
- Pain may radiate to other regions, such as up toward the calf and down toward the toes
What are the potential factors associated with the development of plantar fasciitis?
- Daily demands involving extended periods of standing or walking
- Sudden change in physical stresses placed upon the feet (sudden change in activity level)
- Shoes with poor support or cushioning
- Limitation in calf flexibility
- Excessive pronation (flattening of medial arch) while walking or running
What treatment options are available for this condition?
If you are experiencing heel pain, it is recommended to follow up with a physician to have the region examined and diagnosed. The physician can rule out other potential conditions and present the appropriate treatment options. Potential treatment options which may be suggested if indicated include:
- Physical Therapy – a program may include specific calf and plantar fascia stretches, manual therapy (deep tissue massage), taping techniques, strengthening exercises targeting the gluteals and abdominals as well as intrinsic foot muscles, and instruction in a home exercise program
- Anti-inflammatory medication prescribed by physician
- Night splinting
- Shoe modification and/or orthotics
- Massage – using a golf ball or a frozen water ball can help
This article was written by Matt Hosokawa, PT, DPT from Athletico-West Loop..