Plantar Fasciitis? Two Lesser Known Causes of Heel Pain

You may have encountered thin layers of tissue somewhat like plastic wrap when handling raw meat--that is fascia. Fascia is a contiguous network of connective tissue that runs throughout the body. It thickens to create ligaments and tendons and deep down it wraps around the bones. At the bone level, the fascia is called periosteum.

The plantar fascia is primarily a ligament that connects bones in the ball of your foot to your heel bone (calcaneus). This thick fibrous band of connective tissue is the primary support on the plantar aspect (bottom) of the foot. Plantar fasciosis is the correct term for any "condition" of the plantar fascia. However, the term "plantar fasciitis," which literally means inflammation of the plantar fascia, is most often used. Plantar fasciitis is sometimes also termed runner's heel. In days gone by, it was often called policeman's heel.

If you are interested in plantar fasciitis information because you have been diagnosed with it, or if you've determined on your own that you may have it, learning of these lesser known causes of heel pain could be of great help to you.

A myofascial trigger point (TrP or TP) is a small nodule in a taut band of skeletal muscle. Trigger points are hyper-irritable, exquisitely tender spots. Pressing a TP with the finger elicits a "twitch" response in the muscle. Trigger points can send pain to another area (referred pain) through a neuromuscular mechanism.

Doctors Janet Travell and David Simons have provided effective treatment methods for trigger points based on nearly half a century of extensive research and testing. They have mapped the trigger points and presented them in their widely acclaimed and extremly well illustrated books entitled Myofascial Pain and Dysfunction, The Trigger Point Manual, Volume I and Volume 2.

Travell and Simons suggest that many cases mistakenly believed to be plantar fasciitis are actually due to a trigger point in the calf muscle. If heel pain is due to a trigger point in the calf, no treatment of the plantar fascia will stop the pain. The good news is that this trigger point is easy to eliminate!

The TP that causes heel pain is in the soleus muscle, a part of the calf muscle group. There are a couple more TPs in the soleus that can become activated, but the one that refers pain to the heel is the most distal, located furthest down leg. In the picture to the right, the location of this TP is indicated by the red "X."

It's easy to find out whether this soleus muscle TP is contributing to your heel pain. Guided by the image above, start at the back of the painful heel and run your finger up the calf until you arrive at the area indicated by the red "X" in the picture. Press around that vicinity, seeking a tender spot. If the trigger point is active, it will be quite tender and you may exclaim. If pressing the spot creates or exaggerates the same pain that you've been treating as plantar fasciitis, the TP is likely part or perhaps the only cause of the heel pain.

Self-therapy can be done to eliminate trigger points and there are some excellent reference books in which you can find instruction. The better choice for most people is to seek out a physical therapist or certified massage therapist that is trained in myofascial trigger point therapy.

It may sound far-fetched that heel pain can be connected to the state of one's reproductive organ health, yet in the ancient healing art of foot reflexology, there is no question it can be so.

Foot reflexology is a massage technique based on mapping of the entire body on the feet. Theoretically, the body map on the foot mirrors the organs and systems of the body and when an area on the foot body map is pressed, there is a positive reflex response in the actual corresponding body part.

The typical location of pain in plantar fasciitis is at the site where the plantar fascia connects to the heel bone. Let's compare this to the area of the foot indicated for reproductive organs on the reflexology chart.

As you can see by the body map on the foot reflexology chart to the right, the area on the heel indicating reproductive organs directly corresponds to the most common site for heel pain.

This information is presented in case you would like to investigate the validity of foot reflexology for yourself in regards to heel pain. If you know you have a related condition, knowing about this reflex area on the foot might be enlightening. If you are a woman you can monitor yourself to see if your heel pain flares at particular times in your cycles.

There are many excellent books available on foot reflexology if you would like to learn more. Also, foot reflexologists are massage therapists that specialize exclusively in massage of the foot reflexes to enhance wellness. If you don't know of any, you can do an Internet search for "Reflexologists" or check your local yellow pages. If you don't find a yellow pages listing under "Reflexologists," try "Massage Therapy" and look for display advertisements indicating a specialty in foot reflexology.