Heel pain and planter fasciitis

Heel pain

A podiatrist will determine the cause of the heel pain. Most heel pain is caused by mechanical injury. This could be small repetitive injuries that can occur faster than the body can heal. It can also be due to injuries/lower back problems and inflammatory joint conditions.

Planter Fasciitis

Damage to tissue (fascia) that connects the heel bone to the base of the toes. It tends to be painful, particularly on rising in the morning. Treatments include special stretching exercises and foot assessment to check alignment problems and other possible causes.

Tarsal Tunnel Syndrome

Can present as a burning or tingling sensation underneath the heel and in the arch of the foot. Caused by compression of the tibial nerve as it passes the inside of the ankle. Special shoe inserts can reduce the pressure and may be appropriate for certain foot types. Local injections to reduce inflammation may be necessary.

Calcaneal Bursitis

Inflammation of a bursa (a fluid filled fibrous sac) under the heel bone. The pain typically is more to the centre of the heel and can worsen during the day. Medication and ultrasound can give relief but for long-term relief a shoe insert may be necessary.

Chronic Inflammation

Caused by a heavy heel strike or sometimes a reduction in the thickness of the heel pad that can give rise to a dull ache in the heel when standing and walking that increases during the day. A soft heel cushion can help.

Stress Fracture

This can occur following injury. If a fracture is suspected an X-ray would be required to confirm diagnosis and determine the extent of the injury and therefore treatment protocol.

Severs disease

This condition affects young children, normally between the ages of 8 and 12. It occurs when part of the heel bone suffers a temporary loss of blood supply and as a result the bone dies only to reform when the blood supply is later restored. It is a condition known as osteochondrosis that can occur in growing bones and one that fortunately is self-limiting but can be painful at the time.

Achilles Tendonosis

This can occur when the Achilles tendon is placed under more tension than it is able to cope with and as a result small tears develop. These then become a source of further injury and gradually a swelling may develop within the tendon. Treatment will involve special exercises to strengthen the tendon and temporarily increasing the height of the heel with an insole.

Other forms of pain associated with the Achilles tendon include paratendonitis (involving tissues surrounding the tendon) and Achilles enthesis (inflammation of the insertion of the tendon to the heel). Once again differentiating between these conditions is important as each requires slightly different treatments.

Biomechanical assessment, gait analysis and prescription orthotics

This is the study of pain and discomfort related to the function of the foot.

An assessment includes a thorough understanding of the history of your problem/pain.

Both weight-bearing and non weight-bearing assessment of the joints, muscles and foot angles is carried out.

We will also check pressure using our foot scanner and carry out gait assessments.

Footwear is also checked.

A treatment plan can then be discussed.

Treatments include:

  • Stretch and exercise plans
  • Mobilisations/strapping
  • Footwear advice
  • Accommodative insoles
  • Prescription orthotics

Biomechanical assessment is helpful for the following conditions:

  • Tibialis posterior dysfunction
  • Heel pain and plantar fasciitis
  • Subtalar joint problems
  • Ankle joint pain
  • Metatarsal problems and bunions
  • Metatarsalgia
  • Morton’s neuroma
  • Toe deformities
  • Knee problems
  • Lower back pain

For pain due to poor foot function

Misalignment of muscles and bones can lead to abnormal foot and leg movements resulting in pain due to high stresses on joints and muscles. Orthotics can be used to minimise these movements and reduce stress fatigue and pain and also improve alignment of the body.

We carry out a detailed assessment and use computerised technology to aid with gait analysis. A suitable orthotic can be prescribed that provides control through shape and material density.

Verruca treatment

Verruca or plantar warts are caused by the Human Papilloma Virus.

They may be single or multiple mosaic verruca.

They have become very resistant to conventional treatment so we therefore use a combination of treatments depending on pain, position and size of lesion.

Treatments include cryotherapy (freezing) and chemicals.

The aim of these treatments is to stimulate the body’s immune response.

Introducing our new Swift microwave system to treat verruca

What is SWIFT®?

Swift is a new technology, developed in the UK, which has been licensed for the general treatment of skin lesions in podiatry and dermatology. Swift uses microwave energy delivered through a special probe applied to the skin to treat the affected tissue.

Does it hurt?

Like many treatments for skin lesions, some minor discomfort may be experienced. The majority of patients liken the discomfort to an injection or scratch, lasting 2-3 seconds.

What should I expect after treatment?

In some cases the treated area may feel sore but most people will have no pain after the treatment and can continue their day-to-day activities.

How many treatments will I need?

This will be dependent on how you respond to treatment. In some cases you may need more than one treatment. If this is the case we will be able to advise the best treatment plan for you.

Can anyone receive this treatment?

Most people with skin lesions will be able to receive this treatment. An assessment will be carried out prior to treatment to determine suitability.

Healing rate
There is a 92% healing rate after 3-4 treatments.

Rheumatoid footcare

The skin can become thin and pressure points can develop which may lead to ulceration.

Removal of corns, protective padding

Cushioning insoles

Prescription insoles if required

Footwear advice

Diabetic footcare and assessment

Diabetics can suffer with peripheral neuropathy making the feet feel numb.

Patients are made aware of diabetic foot care to prevent infection.

Circulation, nerves, skin conditions, pressure points and risk factors are monitored.

A yearly report is provided for your doctor.

Nail conditions


Damage or trauma to the nail matrix results in the nail cell shape being altered resulting in a thicker nail.

Certain medical conditions and treatments can also damage the nail.

The nail tends to be thick, curved and discoloured with debris under the nail.

Using our Podospray Drill the nail thickness is reduced and pressure taken off the nail bed.


Ingrowing toenails can be due to poor nail cutting or trauma and are increasingly seen at the clinic due to patients undergoing chemotherapy. The nail can become very inflamed, painful and infected.

Often, conservative treatment can solve the problem but if necessary surgical removal of the nail is necessary using a local anesthetic.


We offer help and advice to return the nail back to a healthy state.


Corns are a hard painful area usually on a bony prominence or the sole of the foot due to abnormal pressures.

They can also occur in between the toes.

The nail tends to be thick, curved and discoloured with debris under the nail.

At the clinic we provide a thorough debridement of the corns/callous and provide protective padding.

Advice on appropriate footwear/socks.

Abnormal mechanical shearing forces and foot function checked.

Foot and ankle anatomy

The foot is a very complex structure made up of:

  • 28 bones
  • 19 muscles
  • 107 ligaments

It is divided into:


This comprises the largest bone in the foot, the calcaneus. This articulates with the talus and forms the subtalar joint. This joint plays a very significant role in the function of the foot.


This contains the 5 tarsal bones, the cuboid and the navicular, which articulate with the medial, intermediate and lateral cuneiform.


This contains the 5 metatarsals, 14 phalanges in the toes and 2 sesamoids under the first metatarsal phalangeal joint.


The talocrural joint or ankle joint consists of 3 articulations. The talus articulates with the tibia and fibula. The joint is maintained by the strong deltoid ligament on the inside and weaker ligaments on the outside, such as the anterior talofibular ligament.

The ankle allows the foot to move:

  • Up and down (plantar flexion and dorsiflexion)
  • Left and right (abduction and adduction)
  • Rotate left and right (inversion and eversion)

Altered function in any of these areas can cause foot problems and lead to symptoms such as pain, corns, callous, toenail pathologies, ingrowing toenails and ulcerations.