Mastering Plantar Heel Pain In Athletes

By Patrick J. Nunan, DPM

   Plantar heel pain is one of the most common maladies we see in podiatric practice. Patients learn on their first visit that the symptoms usually respond to conservative treatment over a six- to 12-week timeframe, although some individuals may take six to 12 months to be totally pain-free. Athletes may have difficulty accepting the fact that they may have lingering pain over six to 12 months. Not only may the athlete be upset, one may also draw the ire of the coach, athletic trainer, agent or parent.    When treating an athlete with plantar heel pain, podiatrists must understand the mechanism of injury, the biomechanical demands of the sport, shoe gear and playing surface, the age of the athlete and the psychosocial effect of the sport on the athlete.    Plantar heel pain among athletes is usually due to overuse and poor biomechanics. However, traumatic causes such as slipping off a curb when running or a baseball player coming down too hard on first base can occur. Excessive pronation is often associated with plantar heel pain, although it can occur in the supinated or pes cavus foot. Muscle strength imbalance and muscle tightness have also been indicated as causes of plantar heel pain. Other possible contributing factors to plantar heel pain include loss of the plantar fat pad with advancing age, increased body weight or hard playing surfaces.1,2

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