Heel Pain, Plantar Fasciitis & Achilles Tendonitis

Heel pain

Heel pain can be a real pain in-the-you-know-what!  Every step can feel like little knives piercing into the flesh.  We limp, we feel old, we feel helpless.  Most of all, all the fun things that we like to do – walking, running, being barefoot or simply going shopping, are either avoided or greatly impeded.  What causes heel pain and what can be done about it?

There are two main types of heel pain – plantar fasciitis and achilles tendonitis.  You can do an internet search to find out all of the wonderful details about the anatomy of these structures (80 % of heel resolves within one year, heel pain, test for heel spurs) however briefly…

Plantar Fasciitis is heel pain on the bottom of the heel.  It hurts to walk, sometimes even just standing is difficult, running is impossible and it especially hurts in the morning.  Fascia is a thick, fibrousy material that is similar to ligaments and tendons.  It can become overstressed and can tear – the resultant injury is called Fasciitis. Treatment can include orthotics, stretching, massaging, ultrasound and chiropractic adjustments to the bones of the feet.  It can (and often does) take a long time to heal and while this injury is not serious, it can be somewhat depressing since we need to stop what we love to do and enduring pain itself is depressing.  Read this for an overall summary of PF.  Recently there have been some studies published on the latest treatment for PF.  I found the findings to be quite an eye-opener and have started using this information in my treatments.  Below are links to two articles; be warned they are quite technical and wordy, so I will summarize the important stuff in this writing.

Achilles Tendonitis is heel pain at the back of the heel.  The tendon is tender to the touch, is often thickened and pain is worse with running or jumping.  The treatment protocol is similar to PF, however many of these conditions are chronic, requiring a different approach.

  • the terms tendonitis and fasciitis imply inflammation, however these conditions are more correctly a tendinosis which necessitates a much different treatment approach
  • exercise and stretches can be good, bad or somewhat neutral – they need to be done with  a certain timing and rhythm to be most effective
  • healing of PF and AT requires that we treat the nerves as well.  The central nervous system (the spine & brain) are key to healing these two stubborn conditions.



On Thursday March 31st 2016 @ 7:00 PM we will be hosting a special Plantar Fasciitis & Achilles Tendonitis Workshop.  Becky and I will going over self-care / home-care strategies and we will discuss the importance of stretching vs. strengthening, body mechanics & alignment, returning to activity, starting an exercise program, footwear and nutrition/supplements for the healing of soft tissue injuries.  The cost of this workshop is $20 per person, $30 per pair.

Finally, our March newsletter has been dedicated to Plantar Fasciitis / Achilles Tendonitis.  Click here to have a read and pass it on (40-60 % of people experience heel pain at one point in their lives, therefore someone you know probably has this condition right now!).

Dr. Nick