What’s the difference between Achilles Tendonitis and Plantar Fasciitis?
Achilles Tendonitis is back of the heel pain. Plantar Fasciitis is heel pain located on the bottom of the heel.
What is Plantar Fasciitis?
Plantar fasciitis is an inflammation of a ligament on the bottom of your foot. It generally occurs at the ligament’s attachment point on the bottom of your heel bone.
What are the causes of Plantar Fasciitis?
Plantar fasciitis is caused primarily by a mechanical default – basically your foot type! – and overuse.
- It happens frequently in active people because they are using their muscles and legs often and may not know about how their foot type works to get them around.
- It is made worse by a tight Achilles tendon. This tendon attaches to the back of your heel bone and is very strong (the strongest tendon in the body!) The Achilles tendon will get a mechanical advantage if it is tight this will lead to it pulling up and back on your heel bone. The area of least resistance where all that pressure will go is to the attachment of the plantar fascia ligament on the bottom of your heel bone.
How is Plantar Fasciitis diagnosed?
Plantar fasciitis is diagnosed through:
- A thorough clinical examination - checking how tight that Achilles tendon is as well as checking as to where the pain is felt on your heel
- Careful history taking - does it hurt at the first step of the day? Have you begun exercising lately? Did you wear unsupportive shoes recently for a long time?
- Diagnostic tools – x-rays can sometimes show a ‘spur’ on the bottom or back of the heel bone (this spur is the result of the pulling of the plantar fascia, not the cause!) diagnostic ultrasound can show the amount of inflammation in the fascia and if there are any tears in the fascia.
How is Plantar Fasciitis treated?
We treat plantar fasciitis in 2 main ways:
1. Address the Inflammation with:
- Regular icing and use of topical medications like BioFreeze
- Anti-inflammatory medications
- Laser or physical therapy
- Cortisone Injections or pills (if needed!)
2. Address the Faulty Mechanics with:
- Proper stretching techniques and the timing of stretches (before you get up!)
- Powerstep Medical Grade Inserts
- Stretching splint that can be worn for 20-30 minutes/day to further stretch the plantar fascia and Achilles tendon
- Athletic strappings and orthotics if needed
- Physical therapy
- Surgery (this is very rare!)
How will changing shoe gear help treat heel pain?
When shoes are brand new, they're providing the support that they were designed and intended to. However, as shoes wear down, they lose this support. There are also shoes that didn't have much in the way of proper support to being with.
By changing shoe gear and transitioning into a more supportive shoe, you're providing your foot with a solution to any mechanical irregularities in the way that you walk. The shoe will support your arch and cause less stress on your tendons, which decreases pain. It will also prevent further complications such as fallen arches.
How will losing weight help treat heel pain?
Your feet have to support and carry your entire body weight. Extra pounds put extra stress on the plantar fascia.
What if stretching, icing, and convenience items don't help?
Stretching and icing are just the 'basics' in regards to heel pain treatment. If you have tried stretching, icing, stretching splint, shoe modifications, anti-inflammatory medications, and conveniences items but are still experiencing pain we have additional treatment options, including:
- Custom Orthotics which change biomechanical imbalances in your foot, the causes the heel pain.
- Steriod injections reduce inflammation and relieve pain.
- Walking boots can immobilize the foot for a short period of time, allowing it to rest and heal. Walking boots keep the foot at and angle, constantly stretching the plantar fascia so it does not tighten and cause pain.
- Physical therapy offers a wide range of intense exercises to loosen the plantar fascia.
- In severe cases, surgical options are also available.
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