Q: What type of heel pain can I treat with this plan?

If you’ve been told you have plantar fasciitis and a heel spur, don’t worry — either plan will work. Heel pain often has more than one cause, so we’ve designed both rehab plans to cover all the bases. If you have any of the following diagnoses, the Plantar Fasciitis Rehab Plan in the Exakt App is suitable for you: Plantar fasciitis: An overuse injury of the plantar fascia Heel spur: A heel spur itself won't go away with physiotherapy, but the associated pain can be managed with our rehab plan

Q: What causes plantar fasciitis?

How plantar fasciitis and heel spurs are linked Plantar fasciitis is an overload injury that develops when the force passing through your foot exceeds what the plantar fascia can handle. Bony spurs — like heel spurs — can form anywhere there’s too much pressure or strain on a bone. It’s thought that heel spurs develop when an overloaded plantar fascia pulls excessively on its attachment to the heel bone. What causes the overload? Activities that can increase the forces through your feet and cause heel pain include: Running, walking, or standing a lot in unsupportive shoes Running, walking, or standing on hard surfaces like concrete Carrying heavy objects or gaining weight Suddenly increasing your running or walking volume Weak foot and leg muscles Excessively tight muscles in the back of your legs (glutes, hamstrings, calves) Perimenopause or menopause may also contribute to plantar fasciitis. This is because lower estrogen levels reduce your body’s ability to produce and repair collagen fibers. Since collagen is the primary building block of the plantar fascia, the drop in collagen production and repair can increase your risk of developing plantar fasciitis.

Question 1

What is plantar fasciitis?

Accepted Answer

Plantar fasciitis is the most common cause of pain under the heel in athletes and non-athletes.

The plantar fascia is a thick fibrous band of fascia (sinewy tissue) under your foot, running from your heel bone to the ball of your foot. Its main job is to support your foot’s arch and prevent it from flattening out when you place weight through your leg.

Plantar fasciitis is an overuse injury and most commonly affects the plantar fascia at its attachment to the heel bone.

Doctors sometimes use the diagnosis “heel spur” as a synonym for plantar fasciitis. This isn’t a problem, as the two conditions are related, share similar symptoms, and are treated the same way.

Question 2

Heel spur or plantar fasciitis?

Accepted Answer

Did you know that researchers are now advising against using the terms “plantar fasciitis” and “heel spur” to describe heel pain?

They believe these diagnoses are outdated and not all that accurate.

Plantar fasciitis traditionally refers to an overuse injury of the plantar fascia and typically shows up as a thickening of the tissue on scans.

Heel spurs are small bony growths that form under the heel bone – usually triggered by overuse or poor foot mechanics. While spurs sound like they should be painful, studies have shown that many people have heel spurs without even knowing it – so they don’t necessarily cause pain.

But researchers point out that people who experience the typical heel pain we tend to label as “plantar fasciitis” or “a heel spur” usually have multiple structures in that area that are irritated or injured. So you can’t really blame just one of them for the pain.

The better term or diagnosis to use is “plantar heel pain”, which simply means pain under the heel that can come from several different structures.

How does this influence treatment?

The same treatments that help with “plantar fasciitis” also work for “heel spur.”

What’s important is that the treatment is tailored to your pain and your stage of recovery. The Exakt app gives you the tools and guidance to move forward at the pace that’s right for you.

Question 3

What type of heel pain can I treat with this plan?

Accepted Answer

If you’ve been told you have plantar fasciitis and a heel spur, don’t worry — either plan will work. Heel pain often has more than one cause, so we’ve designed both rehab plans to cover all the bases.

If you have any of the following diagnoses, the Plantar Fasciitis Rehab Plan in the Exakt App is suitable for you:

Plantar fasciitis: An overuse injury of the plantar fascia
Heel spur: A heel spur itself won't go away with physiotherapy, but the associated pain can be managed with our rehab plan

Question 4

Symptoms of plantar fasciitis

Accepted Answer

The symptoms of plantar fasciitis are very similar to those of heel spurs. Since the underlying causes and treatments are the same for both conditions, it’s not a major concern if you’re not completely sure which one is behind your heel pain.

The most common symptoms include:

The pain is mainly located close to the heel and in the inner part of the foot arch, where the plantar fascia attaches to the heel bone.
It’s usually not associated with pins and needles, tingling, or numbness — if you have any of these symptoms, it’s likely something else.
You may notice some puffiness or swelling in the area of the inner arch, under the foot, but it will not cause swelling around your ankle or on top of your foot.
It doesn’t hurt while you’re sleeping or lying down.
The first few steps in the morning will likely be the most painful and stiff, and it is common for people to hobble around until their foot warms up.
If you sit still for long periods during the day, your foot may feel stiff and painful when you start walking again.
Standing still in one spot can be very uncomfortable.
Discomfort with walking and running can vary depending on how irritated your heel is. In mild cases, you may find that it hurts a bit to start, then feels OK when it warms up, only to hurt more afterward. In severe cases, however, you’ll likely find that the more you walk or run, the worse the pain gets.

Other conditions often misdiagnosed as plantar fasciitis or heel spurs include tarsal tunnel syndrome, stress fractures of the heel bone, and heel fat pad irritation.

Question 5

When to see your doctor

Accepted Answer

You should consult your doctor or physical therapist before using the app to ensure you have the correct diagnosis and are ready to start rehab exercises.

If you have any concerns about your injury after you've started your rehab, schedule a review with your doctor, particularly if:

You feel a sudden sharp pain in your foot during activity — this may mean you've strained or torn something, and the App's program may no longer be appropriate
Any part of your leg (thigh, calf, or foot) is swollen, red, hot to touch, or throbs with pain — these signs can indicate a blood clot, and you should have it investigated as soon as possible
You have pain at night that keeps you awake or interrupts your sleep
You feel pins and needles or tingling in your leg or foot — this can indicate an injured nerve, and our rehab plan may not suit you
Your symptoms are getting worse
Your injury is not recovering as expected (see expected recovery times below)

If you have a chronic condition, e.g., osteoporosis, heart disease, or an inflammatory condition, the rehab plans in the app are likely not appropriate for you. Please check with your doctor before using the app.

Question 6

What causes plantar fasciitis?

Accepted Answer

How plantar fasciitis and heel spurs are linked

Plantar fasciitis is an overload injury that develops when the force passing through your foot exceeds what the plantar fascia can handle.

Bony spurs — like heel spurs — can form anywhere there’s too much pressure or strain on a bone. It’s thought that heel spurs develop when an overloaded plantar fascia pulls excessively on its attachment to the heel bone.

What causes the overload?

Activities that can increase the forces through your feet and cause heel pain include:

Running, walking, or standing a lot in unsupportive shoes
Running, walking, or standing on hard surfaces like concrete
Carrying heavy objects or gaining weight
Suddenly increasing your running or walking volume
Weak foot and leg muscles
Excessively tight muscles in the back of your legs (glutes, hamstrings, calves)

Perimenopause or menopause may also contribute to plantar fasciitis. This is because lower estrogen levels reduce your body’s ability to produce and repair collagen fibers. Since collagen is the primary building block of the plantar fascia, the drop in collagen production and repair can increase your risk of developing plantar fasciitis.

Question 7

What are the best treatments for plantar fasciitis?

Accepted Answer

While evidence suggests that the same treatments work for both plantar fasciitis and heel spur-related pain, there isn’t one approach that works for everyone.

What works for you will depend on the underlying cause of your symptoms – and combining different treatments usually gives the best results.

The following home treatments have been shown to help:

Relative rest: Cut out aggravating activities and reduce your training program to allow your pain to settle
Cushioned shoes and insoles with arch support: These are especially helpful if you spend a lot of time standing or walking on hard surfaces
A slow, progressive strength training plan: Gradually restore your plantar fascia's load tolerance, targeting your foot muscles
General strength and control exercises: Condition your core and other supporting muscles (glutes, hamstrings, and calf muscles) to help share the load when you walk, run, and jump
Mobility and range of movement exercises: Gain and maintain good flexibility in your glutes, hamstrings, and calf muscles to reduce the pull on your plantar fascia
Plantar fascia stretches: Not too aggressive as they can irritate your injury
Self-massage of the plantar fascia and other leg muscles: May help relax the muscles and reduce pain

The rehab plan in the App includes all of these components. It starts with low-load exercises that help settle your pain, then slowly increases the exercise intensity as your foot strengthens and heals.Other treatments you may encounter:

Night splints can be helpful in some cases
Taping to support the arch of your foot can reduce pain — if you find this helps, you may benefit from using supportive insoles in your shoes
Losing weight can reduce the load on your plantar fascia
Shockwave treatment may help to reduce pain in chronic cases
Corticosteroid injections can reduce pain in the short term but may interfere with long-term recovery and are generally not advised

Question 8

How long will my recovery take?

Accepted Answer

If you respond quickly and start with the right treatments within a few weeks of experiencing your first symptoms, it is possible to fully recover within 12 weeks.

But, if you ignore your heel pain and carry on with your usual activities, it can take 12 months or longer to resolve.

Question 9

How can I avoid getting plantar fasciitis?

Accepted Answer

You may reduce your chances of getting heel pain if you:

Wear supportive shoes
Do regular strength training for your core and general leg muscles
Avoid sudden increases in training volume and intensity
Avoid sudden weight gain or if you have gained weight, take steps to temporarily reduce the impact during your training sessions
Transition slowly and run only short distances when switching to less supportive, minimalist shoes
Adjust your training when you enter perimenopause to compensate for the changes in collagen production

Once you’ve completed your rehab, switch to one of the running training plans in the App — we’ve designed them with all these elements in mind.

Question 10

Research references

Accepted Answer

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