Heel Pain

Suffering from Heel Pain? 

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The heel bone, also known as the calcaneus, is the largest of the 26 bones in the human foot, which also has 33 joints and a network of more than 100 tendons, muscles, and ligaments. Like all bones, it is subject to outside influences that can affect its integrity and its ability to keep us on our feet. Heel pain, sometimes disabling, can occur in the front, back, or bottom of the heel.

 

Causes

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There can be many causes of heel pain. Heel pain is generally the result of faulty biomechanics (walking gait abnormalities) that place too much stress on the heel bone and the soft tissues that attach 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 (such as flimsy flip-flops); or being overweight.

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Common causes of heel pain include:

• Plantar fasciitis with or without an associated heel spur

• Excessive pronation 

• Achilles tendonitis 

• Haglund's deformity ("pump bump")-  a bone enlargement at the back of the heel bone in the area where the Achilles tendon attaches to the bone. 

• Bone bruise or contusion

• Underlying systemic disorder such as rheumatoid arthritis that may manifest as heel pain 

• An inflamed bursa (bursitis)

• Stress fracture of the calcaneus

 

What is Plantar Fasciitis? 

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Plantar Fasciitis is the most common cause of heel pain. It is a degenerative condition in which there is chronic and repetitive stress applied to the band of fibrous connective tissue (fascia) running along the bottom (plantar surface) of the foot, from the heel to the ball of the foot. It is common among athletes who run and jump a lot, and it can be quite painful. In the early stage, you will feel the pain mostly when you take your first steps out of bed in the morning or after a long rest, and then the pain will subside as you move.Plantar fasciitis pain may also occur at the beginning of a run, walk, or other physical activity. When plantar fasciitis progresses, the pain grows in intensity and lingers for longer.

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The condition occurs when the plantar fascia is strained over time beyond its normal extension, causing the soft tissue fibers of the fascia to tear or stretch at points along its length; this leads to inflammation, pain, and possibly the growth of a bone spur where the plantar fascia attaches to the heel bone. 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.

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Resting provides only temporary relief. When you resume walking, particularly after a night's sleep, you may experience a sudden elongation of the fascia band, which stretches and pulls on the heel. As you walk, the heel pain may lessen or even disappear, but that may be just a false r possible causes of heel pain include:

 

When to Visit a Podiatrist

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Dr. Tien is the leading foot and ankle specialist in Orange County, so if pain and other symptoms of inflammation—redness, swelling, or heat persist, limit normal daily activities and make an appointment to see her today. 

 

Diagnosis and Treatment

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Dr. Tien will examine the area and may perform diagnostic X-rays to rule out problems of the bone. Early treatment might involve oral or injectable anti-inflammatory medication, exercise and shoe recommendations, taping or strapping, or use of shoe inserts or orthotic devices. Taping or strapping supports the foot, placing stressed muscles and tendons in a physiologically restful state. Physical therapy may be used in conjunction with such treatments. A custom functional orthotic device may be prescribed for correcting biomechanical imbalance, controlling excessive pronation, and supporting the ligaments and tendons attaching to the heel bone. It will effectively treat the majority of heel and arch pain without the need for surgery. The recovery process for heel pain is variable from weeks to months, so it is imperative to be diligent with your treatment. 

 

Only a small handful of cases of heel pain require more advanced treatments or surgery. If surgery is necessary, it may involve the release of the plantar fascia, removal of a spur, removal of a bursa, or removal of other soft-tissue growth.

 

Prevention

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• Wear shoes that fit well—front, back, and sides—and have shock-absorbent soles, rigid shanks, and supportive heel counters

• Wear the proper shoes for each activity

• Do not wear shoes with excessive wear on heels or soles

• Prepare properly before exercising. Warm up and do stretching exercises before and after running.

• Pace yourself when you participate in athletic activities

• Don't underestimate your body's need for rest and good nutrition

• If obese, lose weight