A common ailment of patients visiting Stretch aside from neck, upper back and lower back pain is heel pain. The causes of this problem are numerous, for example excessive running, poor posture, lack of exercise, muscle imbalance, lack of flexibility, and weak or dormant muscles. Runners or those participating in sports requiring excessive running place the muscles of the lower leg and foot under extreme pressure. This is due to repeated plantar flexion or pointing of the foot, flexion of the toes and flexion at the knees, performed in the mechanics of running.

Two of the major muscles of the lower leg are the Gastrocnemius and the Soleus.The Gastrocnemius, characterized by two large heads towards the top of the back of the lower leg, is involved in two actions during running and walking, plantar flexion and knee flexion. It originates from the femur (bone of the upper leg) and inserts via the Achilles tendon onto the heel bone (Calcaneous). The Soleus is so called because it is shaped like the fish called the ‘sole’ and is only involved in pointing of the foot (plantar flexion). It originates at the top of the bones of the lower leg (tibia and fibula) and also inserts via the Achilles tendon onto the heel bone. So both of these muscles blend together and form the Achilles tendon, the body’s most powerful tendon. The Achilles tendon comes under enormous strain, bearing the weight of the entire body in order to push off with the feet when walking and running.

During running the major calf muscles (Gastrocnemius and Soleus) are required to contract repeatedly, causing them to shorten and tighten. This places intense pressure on the insertion of these muscles via the Achilles tendon at the heel bone. In acute circumstances this can cause the Achilles tendon to become inflamed at the heel attachment resulting in subsequent pain. This is known as Achilles tendonitis. For flexion of the toes during running and walking the muscles involved are the Quadratus plantae, the Flexor digitorum brevis, and the flexor Hallucis brevis. These muscles originate from different areas at the base of the foot but they insert onto the base of the heel. This insertion is collectively known as the plantar fascia. As a result of excessive use (contracting) of these muscles and the consequent tightening, stiffening and shortening, the insertion (plantar fascia) can become inflamed causing discomfort. This is known as Plantar fasciitis.

These problems however are not unique to runners. Office workers and people leading sedentary lifestyles are also susceptible to these injuries. As a result of prolonged durations of sitting, hip flexors tighten causing the pelvis to rotate forwards and when standing this causes the person to begin to weight bear forwards on the balls of the feet, instead of on the heels where the body should bear 80% of its weight. Weight bearing on the balls of the feet forces the major muscles of the calf and the base of the foot to continuously contract in order to prevent falling forwards. Consequently these muscles tighten up producing the same outcome that many runners face. As a result of being less active than an athlete, the muscles and their attachments are significantly weaker in the sedentary person because they are less developed. The subsequent injuries incurred can therefore be far more serious. For example any over rigorous movements can result in a partial or complete rupture of the Achilles tendon and/or the plantar fascia, requiring extensive rehabilitation.

At Stretch we can help prevent and treat such injuries by working to improve your overall posture, muscle balance, muscle strength and above all, flexibility to allow the pressure on these areas of the heel to be alleviated.