Medical: Dealing with heel pain

Plantar fasciitis can cause heel pain that makes riding, particularly when stood on the pegs, a painful experience. Here, Suzie Bostock explains how to help prevent its occurrence, and what to do if you’ve got it.

One of the most common causes of heel pain is plantar fasciitis (or plantar fasciopathy). The Plantar Fascia is a strong band of fascial tissue which runs from the heel bone (calcaneus) and fans out to attach to the base (proximal phalanx) of each toe. It plays a very important role in supporting the arch of the foot and as you load your foot, the plantar fascia elongates in order to act as a shock absorber. 

It may affect up to 10% of people within their lifetime. Motorcyclists, especially those that ride off-road a lot, stand up on their pegs, have eaten too many pies or spend a lot of other time on their feet are more at risk, especially if their boots offer minimal or low levels of support. If you’ve had a previous foot or ankle injury resulting in decreased movement in your ankle, foot or toes, you can also be more at risk.

 Plantar fasciopathy can cause a lot of pain in the heel, especially after long periods of standing, however it’s normally especially painful first thing in the morning when you take your first few steps after being in bed all night. 

The most common treatment for this condition is advice, education and self-management with exercises. The exercises and advice below can get you started off in the right direction, however if you are not noticing any change in your symptoms after the first couple of weeks of undertaking the exercises on a daily basis, or a worsening of symptoms, you should make an appointment with your GP or a physiotherapist for assessment to ensure your heel pain is definitely plantar fasciopathy and/ or if any other treatments may be helpful. It’s advisable to do these exercises on both sides if you have time, not just on your painful side.

Calf Stretch (Gastrocnemius) 

Stand facing a wall. Place your hands on the wall and the foot of the leg to be stretched back, keeping your knee straight, foot flat on the floor pointing forwards. Let your front knee bend until you feel a stretch in your calf. Hold 30 seconds and repeat 3-4 times. Do this 3-4 times a day. 

Calf Stretch (Gastrocnemius)

Calf Stretch (Soleus) 

Stand facing a wall. Place your hands on the wall and the foot of the leg to be stretched back, allowing your knee to bend slightly, foot flat on the floor pointing forwards. Let your front knee bend until you feel a stretch in your calf. Hold 30 seconds and repeat 3-4 times. Do this 3-4 times a day. 

Calf Stretch (Soleus)

Hamstring stretch 

Lie on your back. Keeping your knee straight, lift up the leg that you want to stretch as far as possible until you feel a stretch in the back of your thigh/hamstrings. Use your hands to help and hold your leg in place. If this is too difficult, use a belt to help keep your leg in place instead. Hold 30 seconds and repeat 3-4 times. Do this 3-4 times a day. 

Hamstring stretch

Plantar Fascia / Toe Stretch 

Sit on a chair. Place one foot over the other knee. Hold your foot with one hand and use your other hand to bend back your toes (especially your big toe) as far as comfortable, until you feel a stretch in the underside of your foot. Hold 30 seconds and repeat 3-4 times. Do this 3-4 times a day. 

Plantar Fascia / Toe Stretch

Toe exercises 

Sit down. Place a tea-towel on the floor in front of you. Use your toes to scrunch the towel and lift it off the floor a little, pulling it towards you. Repeat this until you have pulled the length of the towel towards you as much as possible (up to 15 scrunches) and repeat 3 times. To make this a little harder, place a 1kg weight on the towel. You can use upto a 2kg weight depending on your ability and levels of pain. 

Toe exercises

Ice roller 

Freeze a round bottle of water (do not fill completely). Roll your foot on the bottle of water slowly for 10-20 minutes 2-4 times a day. DO NOT do this if you have issues with circulation or if you don’t have full sensation in your foot. Stop exercises that cause increased pain, especially after exercise. 

Ice roller

Other things that may help: 

  • Take regular rests. Don’t spend extended periods of time on your feet which exacerbates the pain. If your job involves spending a lot of time on your feet, discuss with your workplace ways to break this up, or if you’re self-employed try to look at ways in which this may be possible. 
  • Use good quality foot pegs if standing up a lot, and wide foot pegs to reduce strain on the arch of your foot and support your foot. 
  • Invest in good quality, supportive boots that are comfortable. 
  • See a physiotherapist for taping and to discuss night splints. 
  • Try orthotics that support the arch of your foot and cushion your heel. 
  • When not riding, wear proper, supportive footwear. 
  • It may be beneficial to talk to a pharmacist or doctor about NSAIDs (e.g. Ibuprofen). For a reference list or any questions please contact me on suzie@overlanderhealth.com.