Your Heel Pain – It’s Not Always Plantar Fasciitis. Do You Have the Right Diagnosis?

If you’re getting pain at the bottom of your heel that’s worst first thing in the morning and on standing after rest, a lot of the things you read (and people you talk to) will tell you that you’re likely to have plantar fasciitis. But there’s another muscle that has the same insertion in the heel and spans the arch to your big toe – it’s called your abductor hallucis muscle – and it could be true cause of your heel pain and the reason you’re not getting better as fast as you’d expected.

Where is your abductor hallucis and what does it do?

Your abductor hallucis (from hallux, meaning ‘big toe’) is a muscle that spans your arch, beginning at the inner aspect of your heel and attaching to the inner side of your big toe. It helps to move the big toe sideways (like when you splay your feet to grip onto the ground), supports your arch and foot with every step you take, and supports a massive amount of weight (among more technical functions that help).

Why didn’t anyone pick up on it?

Because the plantar fascia and the abductor hallucis start and finish in similar areas (though the plantar fascia attaches to ALL the toes like a fan whereas the abductor hallucis only attaches to the great toe), pain in this area is often mistaken for plantar fasciitis. The abductor hallucis can be stressed and strained in the same way as the fascia – through pronating (feet rolling inwards/flat feet) and other actions that strain the arch, so a diagnosis of plantar fasciitis will often make sense.

Unlike plantar fasciitis, you may experience some numbness beneath your big toe or a deep muscle ache when you’re resting.

What’s the next step?

If you’re worried or your pain isn’t settling, come in and have your feet checked by our expert team. While many modalities of treatment for abductor hallucis tendinopathy overlaps with treatment for plantar fasciitis, a large difference is that as a muscle (whereas the fascia is a tissue), rehabilitation needs to have a greater focus on strengthening the muscle back to its solid, strong state.

Arch support through orthotics are good for relieving tension off the abductor hallucis while it heals and recovers from the damage, but if the muscle has become weakened then there it can be likely that your symptoms may come back when the muscle is placed under excess strain again. Hence, intrinsic strengthening can be key to give the muscle back the strength it needs to adequately support the foot and fulfil it’s functions without incurring damage in the process.

On top of that, our team are trained in various aspects of manual therapy such as acupuncture and trigger point therapy that can be used on the Abductor Hallucis muscle.

Here at The Podiatrist, it is our commitment to get you back on your feet and doing the things you love so you can realise your full potential. We do this by providing thorough and comprehensive examinations to not only provide an accurate diagnosis but to determine the cause of your problem so it doesn’t happen again. We do this as timely, effectively and easily as possible – because pain should not be a normal part of life.