Some common conditions of the heel:Plantar Fasciitis: The plantar fascia is specialized connective tissue on the bottom of the foot that attaches to the heel bone (calcaneous) and runs up to the base of each toe. Plantar fasciitis is inflammation of this connective tissue. Symptoms commonly present as a sharp pain at the heel with weight bearing, especially upon first rising in the morning. It may subside during the day as the bottom of the foot loosens up, or may be a constant ache. While traumatic plantar fasciitis can occur, it is more common a chronic problem due to excessive loading of the foot. In many cases the increased tension on the plantar fascia may contribute to the formation of a bone spur at the front of the heel. Symptoms may be present with or without a spur, and frequently a spur may be present but asymptomatic. In both cases physical therapy treatment is the same, reduction of pain and inflammation, and finding and modifying the cause of the excessive loading on the fascia. In cases where the structure of the foot varies from the norm (high arch, flat feet), generic or custom-made orthotics may be beneficial in reducing the stress to the plantar fascia. Early recognition and treatment of plantar fasciitis is very important in preventing it from becoming a long term or reoccurring problem.
Achilles Tendonitis/Rupture: The Achilles tendon is where the gastroc and soleus (calf) muscles attach to the heel bone. Due to the high forces the calf muscles can generate and the repetitive nature of many athletic activities, the Achilles tendon is at risk to develop inflammation. Treatment is frequently required to reduce inflammation, improve flexibility of the calf muscles, and retrain the neuromuscular system to become more efficient and reduce the stress through the tendon. Occasionally the Achilles tendon can rupture, usually from an activity requiring high force that is generated quickly as in jumping or sprinting. Chronic bouts of tendonitis may weaken the structure of the Achilles tendon and contribute to a rupture. A complete Achilles rupture always requires surgery to repair. Physical therapy is important after surgery to restore mobility, and reeducate the repaired calf muscle to assist with a return to normal walking and functional activities.