We’re continuing our theme this month on hiking injuries. In the last video I talked about what can cause knee pain in hikers and how we treat it. Today I’m going to talk about another common hiking injury – heel pain. Heel pain is a very common complaint in both hikers and runners. A very common diagnosis for heel pain in hikers is Plantar Fasciitis, or inflammation of the connective tissue that supports the arch of your foot.
The plantar fascia attaches to the inside part of your heel, and that’s why this can be one cause of your heel pain. The problem is that not all heel pain is caused by plantar fasciitis. If you’re a hiker with heel pain, you may have tried or at least read online about several different methods of self treatment for heel pain – lacrosse balls, golf balls, heat, ice, kinesiotape, orthotic inserts, or special braces that stretch your foot while you sleep. If plantar fasciitis is not the cause of your heel pain, then perhaps none of those things will work. That is why it’s so important to see your healthcare provider for a proper examination and diagnosis, and your exam needs to include what we call the kinetic chain, or all the joints and tissues upstream from your foot. Your heel pain can be caused by anything from Achilles tendinitis, nerve entrapment at the ankle, peripheral neuropathy, stress fracture, or even a disc injury in your lower back.
Once we’ve gone through a thorough evaluation of a patient with heel pain, there are typically 3 areas we tend to focus on: The lower back, the ankle, and the foot.
If the lower back seems to be contributing to your heel pain, we have several different approaches to help with that. In the office, I can perform chiropractic adjustments as well as use a special table to apply traction to decompress your lower back and relieve pressure on irritated joints and nerve roots that can refer pain to your foot. I will also get you doing some stretches to relieve irritation on the same areas.
In the ankle and lower leg we typically see stiff joints, tight muscles and nerve irritation that contribute to heel pain and a potential diagnosis of plantar fasciitis. For that, we can do some adjusting and mobilization at the ankle, some neuromobilizations to help free up the nerves crossing through there, and deep tissue massage and stretching to loosen up tight muscles.
At the foot, we can also employ chiropractic adjustments, deep tissue massage to the plantar fascia, taping, orthotics, and strengthening exercises to improve the stability of the intrinsic muscles in your foot and reduce strain on the plantar fascia.
In the video above, I demonstrate a couple of mobility drills for the ankle and a strengthening exercise that, in addition to what we offer here at the clinic, can help you beat your heel pain and get back out on the trail.