Heel pain is one of the most common conditions treated by podiatrists. It is often a message from the body that something is in need of medical attention. Pain that occurs right after an injury or early in an illness may play a protective role, often warning us about the damage we have suffered.
Who gets heel pain?
The greatest incidence of heel pain is seen in middle-aged men and women. It is seen in those who take part in regular sporting activities and those who are significantly overweight and on their feet a lot. Heel pain can also occur in children, usually between eight and 13, as they become increasingly active in sporting activities.
The causes of heel pain
It is thought that higher arches or flatter arches, or feet that role in too much, are causes of heel pain. This can place too much stress on the heel bone and the soft tissues attached to it.
The stress may also result from injury, or a bruise incurred while walking, running or jumping on hard surfaces, wearing poorly constructed footwear or being significantly overweight.
Certain diseases an also contribute to heel pain.
One factor sometimes associated with heel pain is the heel spur, a bony growth under the heel bone. There are no visible features on the heel, but a deep, painful spot can be found in or around the middle of the sole of the heel.
Approximately 10 per cent of the population may have heel spurs without any pain.
Heel spurs result from strain on the muscles of the foot. This may result from biomechanical imbalance, a
condition occurring in many people.
Both heel pain and heel spurs are frequently associated with an inflammation of the long band of tissue
that connects the heel and the ball of the foot. The inflammation of this arch area is called plantar fasciitis.
The inflammation may be aggravated by shoes that lack appropriate support, especially in the arch area, and by the chronic irritation that sometimes accompanies an athletic lifestyle.
Other causes of heel pain
- Excessive rolling in of the feet when walking.
- An inflamed bursa (bursitis); a small, irritated sack of fluid at the back or under the heel.
- A neuroma (a nerve growth).
- Other soft-tissue growths.
- Heel bumps, or ‘pump bumps’, a bone enlargement at the back of the heel bone.
- Bruises or stress fractures to the heel bones.
Overcoming the problem
If pain and other symptoms of inflammation – redness, swelling and heat – persist, you should limit normal daily activities and consult your local podiatrist.
Your podiatrist may refer you for x-rays to look for heel spurs or fractures.
Early treatment might involve exercise and shoe recommendations, taping or strapping and
anti-inflammatory medication. Taping or strapping supports the foot, placing stressed muscles in a restful state and preventing straining of the plantar fascia. Other physical therapies may also be used, including ice packs and ultrasound.
These treatments will effectively treat the majority of heel and arch pain without the need for surgery.
Only a relatively few cases of heel pain require surgery. If required, surgery may involve the removal of a spur, but also may involve release of the plantar fascia, removal of a bursa or removal of a neuroma or other soft-tissue growth.
Your recovery will depend on the cause of your heel pain and your individual health. If you are suffering from a heel spur or plantar fasciitis, it normally takes about six to eight weeks for a healthy individual to fully recover. That is when the injured area is fully rested or properly strapped.
Preventing future problems
Wear shoes that fit well – front, back and sides – and have shock-absorbent soles, rigid uppers and supportive heel counters. Do not wear shoes with excessive wear on heels or soles.
Stretches and exercise
Prepare properly before exercising.
Warm-up before running or walking and do some stretching exercises afterwards.
Pace yourself when you participate in athletic activities. If overweight, try non weight-bearing activities such as swimming or cycling.
Your podiatrist may also use taping or strapping to provide extra support for your foot. Orthoses (shoe inserts) specifically made to suit your needs may also be prescribed.
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