Common Causes of Heel Pain and How Physical Therapy May Help

Orthopaedic & Spine Center
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Image of Jonathan Lorusso, LPTA

Jonathan Lorusso, LPTA

At OSC, our orthopaedic physicians treat many patients who complain of heel pain caused by a tendon or ligament that is inflamed and angry.  As an OSC Physical Therapist Assistant, I’m referred these patients to help them overcome their heel pain through exercise and the use of specific modalities designed to reduce inflammation and facilitate healing. I will discuss the two most common causes of heel pain and the exercises we use to help patients who suffer with these conditions.

Plantar Fasciitis – The Plantar Fascia is a ligament that connects at the back of the heel and runs under the heel bone and ends at the toes.  When it becomes inflamed, it can cause extreme heel soreness which is typically worse in the morning upon arising from bed or after prolonged sitting.  It may feel like stepping on a stone or sharp object.

Achilles Tendonitis – the Achilles Tendon connects the calf muscles to the heel.  When inflamed through overuse or repetitive activity, the tendon will typically hurt on the back of the lower calf and sides of the heel vs. underneath it.  We treat Achilles Tendonitis in much the same way as we do Plantar Fasciitis – with lots of stretching and strengthening of the calf muscles.  The same exercises for Plantar Fasciitis are often used for Achilles Tendonitis.

In Physical Therapy, we’ll focus on stretching the Plantar Fascia and Achilles Tendon and strengthening the lower leg muscles.  We may also apply therapeutic tape to your foot to provide extra support.  For Plantar Fasciitis, we may also recommend a night brace to keep your foot and calf stretched while you sleep. Some modalities often used within our clinic to reduce pain or inflammation can consist of low-level laser therapy, ultrasound, instrument-assisted soft tissue mobilization, vibration therapy, moist heat, or electrical stimulation.

Stretching is key here for both conditions.  You’ll be encouraged to stretch many times a day.  An easy stretch to perform is to stand with your toes on the edge of a step and drop your heels down.  Doing so, will over time, ease the pain and inflammation of both conditions.  You can also get a good stretch by placing your hands against the wall and moving the affected foot back with toes pointing to the wall, keeping the toes and heel on the ground while pressing against the wall, feeling a good stretch through the calf and heel.

Strengthening exercises will also help to build muscle to support the tendons and ligaments.  We often use therapeutic bands to help isolate muscle groups and balance exercises to strengthen the muscles in the foot, ankles and calf. Persistence is key.  Both conditions can be hard to overcome and take some effort and determination on the part of the patient to avoid having the issue become a chronic one.  It’s my job to help your reach your goal of decreased pain and inflammation while improving your function and quality of life.

With acute onset of symptoms, it’s important to reduce activities that cause further irritation, such as running, jumping, or excessive walking. Through physical therapy, we’ll gradually progress your activity as symptoms and capability continue to improve.

If you’re interested in making an appointment with physical therapy or another one of our providers, get started online by clicking the “Request Appointment” button below or by calling (757) 596-1900.