Plantar fasciitis
- Heel pain on weight-bearing, mostly in the morning
- Dorsiflex the ankle maximally and dorsiflex the big toe so the plantar fascia is stretched. Palpate medially from the posterior third inwards towards the calcaneus. Record pain at the attachment on the calcaneus.
- Ultrasound and X-ray may show calcification at the attachment on the calcaneus.
Heel spur
- Contusion (for example, from a lot of running on hard surfaces) can cause bleeding in the fat pad under the heel and crushing of the connective tissue septa that hold the fat tissue in place
- Reduces the heel pad's shock-absorbing properties and eventually irritates the periosteum of the calcaneus
Sever's disease (calcaneal apophysitis)
- Seen in children aged 10-15 years
- Irritation in the growth plate of the heel bone
- Tenderness on palpation and slight swelling
- Diagnosed with X-ray
- Resolves on its own