Weakened Foot Strength and Orthotic Use in Patients with Heel Pain

In our previous posts we have documented the weakness and atrophy of the foot's "core" muscles among patients with heel pain.   Heel pain is one of the most common foot and ankle diagnoses we see in our Boulder Physical Therapy Practice.  This condition is commonly treated with manual therapy and exercises targeting the lower quarter.  A targeted area for exercise involves the foot's core muscles which contribute to stability and function of our arch.  Without adequate strength and control of the arch we are more at risk for conditions such as heel pain and plantar fasciitis.  Recent research highlights the importance of these muscles and the negative impact foot orthoses may have on their function. 

McClinton and colleagues studies 27 patients with heel pain compared to matched peers who ddi not have any heel pain (JOSPT 2016).  Participants' foot strength was tested using two clinical tests for foot "core" strength.  Not surprisingly, the patients with heel pain had significantly less foot strength than their asymptomatic peers.  Interestingly, longer use of foot orthoses was associated with lower performance on these strength measurements.   Stabilization of the arch with foot orthotics may weaken the foot's core muscles because they prevent these muscles from performing their natural function.  

Patient's are encouraged to contact their local PT on the most appropriate treatments for their heel and foot pain.