Physical Therapy for Heel Pain

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Physical Therapy for Heel Pain

HOW CAN PHYSICAL THERAPY HELP HEEL PAIN?

Being able to stand and walk throughout the day becomes significantly more difficult when you are living with heel pain. You may be finding that no matter how many rest breaks you take, your heels protest loudly each time you stand on them again. Addressing musculoskeletal pain conditions like heel pain is a specialty of physical therapy. By identifying the potential cause, physical therapists can create a plan to reduce the irritation or inflammation in the heel area and promote return to full activities.

WHAT DOES PHYSICAL THERAPY FOR HEEL PAIN LOOK LIKE?

Physical therapy for heel pain is aimed at identifying the underlying cause, ameliorating symptoms of pain and discomfort in the foot and heel with standing and walking and preventing recurrence of symptoms. My team of therapists and I will start by getting to know your concerns and goals and performing a thorough physical exam to assess the heel area and any adjacent areas that may be contributing to your symptoms. During treatment your therapist may prescribe modalities to lessen inflammation, employ manual therapy interventions to target joint and tissue mobility while also prescribing movements and exercises for strength, motor control and mobility to be performed in the home and the clinic.

WHEN WILL I BEGIN TO SEE RESULTS?

While full resolution of symptoms can take some time, you may begin to see some results right away. You should experience improvements in many symptoms such as pain, stiffness, and inflammation within a couple of weeks. Progression in strength, flexibility and overall mobility that allows you to stand and walk more comfortably, may take longer. Achieving long lasting results may take some time, but dedication to your program will not only help you achieve these results but will help to decrease the likelihood of symptoms recurring in the future.

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HOW DOES HEEL PAIN PRESENT?

Depending on the cause of heel pain, you may experience one or many of these symptoms:

Discomfort with standing or walking on the affected foot
Pain or intense ache in the heel that is often worse first thing in the morning or after a longer period of rest.
Inflammation or swelling over the heel
Tenderness when touching or applying pressure to the area
Warmth over the area
A palpable bony protrusion at the bottom or back of the heel
Pain that is initially worse with activity and better with rest but may progress to occurring at rest as well
Numbness, burning or tingling in the sole or inside of the foot

Interviewing you about the pattern of your symptoms and performing a physical examination will help your physical therapist pinpoint a potential cause of your heel pain. In some cases, they may refer you to see a Podiatrist, Orthopedist, Sports Medicine physician for further examination and imaging.

WHAT ARE SOME COMMON CAUSES OF HEEL PAIN?

Heel pain can be caused by many different conditions. Below is a list of some of the more common causes of heel pain.

Heel spurs: Heel spurs are bone spurs or osteophytes that form on the calcaneal (heel) bone of the foot. These areas of excess bone can cause pain, inflammation, tenderness and joint stiffness in the area. When it develops near the insertion of the achilles tendon it is called a Haglund’s Deformity.

Plantar fasciitis: The plantar fascia is a thick band of connective tissue that supports the arch of the foot. It runs from the heel to the ball of the foot. When inflamed or irritated pain can be felt in the bottom of the heel, along the arch or at the ball of the foot.

Achilles tendinitis: Achilles tendinitis is one of the most common causes of heel pain felt along the back of the heel. Injury or irritation at the attachment site or distal end of the achilles tendon which connects the calf muscle to the calcaneus is a hallmark sign.

Tarsal Tunnel Syndrome: Entrapment of the tibial nerve where it runs beneath a band of ligaments along the inner ankle can cause pain, numbness, tingling or burning along the sole of the foot, including the heel.

Stress fracture: Calcaneal stress fractures can occur in persons participating in high volumes of weight bearing activities like running or marching. Without proper time to rebuild between training sessions, an area of weakened bone can begin to form in the calcaneus and can progress to a frank fracture if left untreated.

Sever’s Disease: The most common cause of heel pain in growing children, Sever’s Disease occurs when the growth plate at the back of the heel becomes inflamed and painful.

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**End Injury Progression**
Physical therapy for heel pain has proven to slow and even stop heel pain, related MSK issues, and injury progression in many cases.

**Relieve Heel Pain**
The movements used in this technique can target your feet, heel, ankle, and calf helping you to manage heel pain during the course of your physical therapy treatments.

**Improve Range of Motion**
Posture awareness is an important area to focus on due to the fact that certain positions or shoes with poor support may cause you further heel pain.

**Restore Mobility**
You can gain mobility and flexibility by taking part in the stretches and exercises as prescribed by your physical therapist.

How Long Will Heel Pain Physical Therapy Treatments Last?

If you decide to work with a physical therapist to help correct your heel pain issues, your entire treatment plan could consist of around 8-20+ different physical therapy for heel pain sessions that will each last 60-90 minutes. Once you complete your customized heel pain physical therapy treatment plan, you will be able to continue to do the prescribed stretches and exercises utilized during your heel pain PT sessions yet in the comfort of your own home.

HOW DO PHYSICAL THERAPISTS TREAT HEEL PAIN?

The treatment of heel pain will depend on the cause of your symptoms. Treatment for plantar fasciitis, for example, will differ from the treatment of achilles tendinitis. So while the specific interventions prescribed for each condition may vary, in general, the goals of physical therapy for heel pain are as follows:

Education: Your PT will spend time educating you on strategies you can implement to manage your symptoms such as the following:

Take breaks from being on your feet, especially in the beginning of your treatment when you are more symptomatic. In some cases you may need to restrict weight bearing significantly through the use of assistive devices.
Wear well-fitting shoes with proper arch support when you will be standing or walking for extended periods
Wear slippers or cushioned shoes for walking on tile or hardwood floors at home
Run or walk on softer surfaces outdoors like grass rather than concrete or gravel
Heel pads or shoe inserts may be recommended to help distribute pressure more evenly across the heel
Make sure to follow your home program for inflammation management, exercises and stretching

Manage inflammation: When present, reducing inflammation over the heel is an important step in relieving the aches and pains it can cause. Some ways your physical therapist may address inflammation are as follows:

Ultrasound
Low level laser treatment
Contrast baths: alternating hot and cold therapy

Improve Joint Motion: Improving motion of the joints in the foot and ankle and the tissues that surround it can improve both pain and function. A program of stretching and mobility exercises may be prescribed to optimize movement and redistribute forces away from the painful heel. Your PT may also gently mobilize the involved joints to help restore motion.

Address muscle and soft tissue limitations: Tight or shortened muscles and fascia may contribute to heel pain caused by a variety of conditions. Soft tissue mobilization, myofascial release techniques and stretching can help improve tissue length and mobility.

Improve Quality of Movement: Improving the quality of movement around the foot and ankle joints, improving calf and ankle muscle strength, controlling pronation and improving the motor control of the foot and ankle may be prescribed to reduce your pain.

If you are living with heel pain, don’t ignore it. Call us today to learn more about our services and schedule an evaluation: Call to Schedule a Consultation! 1-718-258-3300