Is it Plantar Fasciitis or something else?
Pain on palpation markings for medial ankle/ heel pain
You may have heard about Plantar Fasciitis (or more recently referred to as Plantar Fasciopathy) from a friend, colleague or family member that described their debilitating morning heel pain as a nightmare to deal with. So, what exactly is it? Plantar Fasciitis in short is the inflammation of the tissue under the sole of your foot made up of very thick and strong collagen fibres (Health Direct, 2023). The Plantar Fascia has three bands that span across the foot that all originate from your calcaneus (Heel bone) to the metatarsophalangeal joints (toes). There are varying presentations and diagnoses of Plantar Fasciitis depending on factors such as acute vs chronic, the anatomical location of symptoms (Non-insertional or insertional, and medial, central or lateral band), and whether there are any tears or ruptures. According to the National Library of Medicine, the prevalence of Plantar Fasciitis accounts for approximately 10% of running related injuries and 11%-15% of all foot symptoms that require professional medical attention (Buchanan, Sina, & Kushner, 2024).
Despite the prevalence of Plantar fasciitis being high, it does not account for the diagnosis of all heel pain. This is where a detailed clinical history in conjunction with a functional assessment and detailed palpation can identify an accurate diagnosis. Below is a table that categorises the pain location, key symptoms and exacerbating factors associated with conditions that can often be misdiagnosed as Plantar Fasciitis.
Differential Diagnosis for Plantar Fasciitis
Conditions such as Baxter’s Nerve Irritation/ Entrapment, Posterior Tibial Tendonitis, Flexor hallucis Longus Tendonitis and Tarsal Tunnel Syndrome are all located at the inside of the ankle/ heel. In addition to sharing similar pain locations, the key symptoms and aggravating factors share some similarities. It’s also important to note that in some cases more than one diagnosis can exist and this may be confirmed through diagnostic imaging if needed. Needless to say, an accurate diagnosis will generally lead to a more tailored short- and long-term treatment plan and ultimately better outcomes. If you have been experiencing symptoms of heel pain, we recommend booking in to see your local podiatrists for a comprehensive assessment and tailored treatment plan to get you pain free as soon as possible.
At Podiatry Beyond, we recommend booking in an Initial Musculoskeletal Assessment if you are new to the clinic or have not been seen within the last 12 months, otherwise a long musculoskeletal appointment is appropriate for subsequent patients.
