All Posts tagged heel pain

Achilles tendonitis

These exercises are often recommended for Achilles injuries. They are called the Alfredson ‘180 repetition’ calf raise program. The regime is named after the researcher Hakan Alfredson, who stumbled upon this treatment while he was trying to rupture his own degenerative Achilles tendon with repeated bouts of high volume exercising through pain. Instead of rupturing, his Achilles improved. 

Stand on the bottom step of a staircase, facing inwards, hands lightly supporting at either side. The forefoot of the affected leg is placed on the edge of the step.

Lower your body down by dropping the heel of the affected leg over the edge, with control; then place the foot of the non-affected leg on the step to raise the body back up to the starting point. 

If this proves too difficult, or if both Achilles are affected, it is possible to raise back up on two legs (thereby sharing the concentric load) and coming down on a single leg (this is the “2 up, 1 down” concept).

Perform 3 x 15 eccentric heel drops with the knee straight and 3 x 15 repetitions with the knee bent, repeated twice daily.

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Plantar fascitis & foot pronation

Plantar fasciitis or heel spurs are common in sports which involve running, dancing or jumping. Runners who excessively pronate (feet rolling in or flattening) are particularly at risk as the biomechanics of the foot pronating causes additional stretching of the plantar fascia.

Symptoms: A chronic mild ankle sprain could have symptoms related to stretching of the ankle ligaments; mild pain; mild swelling on the outside of the ankle; some joint stiffness or difficulty walking or running.

Plantar fascitis can be heel pain, under the heel and usually on the inside, at the origin of the attachment of the fascia. Sometimes there may also be pain along the outside border of the heel. This may occur due to the offloading the painful side of the heel by walking on the outside border of the foot. It may also be associated with the high impact of landing on the outside of the heel if you have high arched feet. Pain is usually worse first thing in the morning. After a few minutes it eases as the foot gets warmed up, but can get worse again during the day especially if walking a lot. 

How to best treat and prevent this from happening again: Rest until it is not painful. It can be very difficult to rest the foot as most people will be on their feet during the day for work. By walking on the painful foot you are continually aggravating the injury and increasing inflammation. However a good plantar fascitis taping technique can help the foot get the rest it needs by supporting the plantar fascia.

Cold therapy can be applied regularly until symptoms have resolved.

Stretching the calfs and plantar fascia is an important part of treatment and prevention. Simply reducing pain and inflammation alone is unlikely to result in long term recovery. The plantar fascia tightens up making the origin at the heel more susceptible to becoming inflamed. Tightening of the plantar fascia happens in particular over night which is why pain is often worse in the morning. A plantar fascia night splint is an excellent product which is worn over night and gently stretches the calf muscles and plantar fascia preventing it from tightening up overnight.

Arch supports or custom made orthotics are often required.

In office treatment includes using the warm laser, the Deep Muscle Stimulator (DMS), or the ‘scrapping’ tools called Graston or SASTM. I like to use K-tape as well.

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