The most common cause of Heel Pain
is plantar fasciitis which is commonly referred to
as a heel spur. Plantar fascia is a broad band of fibrous tissue which runs along the bottom surface of the foot, from the heel to the toes. Plantar fasciitis is a condition in which the plantar
fascia is inflamed. This condition can be very painful and cause a considerable amount of suffering.
Common causes of heel pain include, Heel Spurs, a bony growth on the underside of the heel bone. The spur, visible by X-ray, appears as a protrusion that can extend forward as much as half an inch.
When there is no indication of bone enlargement, the condition is sometimes referred to as "heel spur syndrome." Heel spurs result from strain on the muscles and ligaments of the foot, by stretching
of the long band of tissue that connects the heel and the ball of the foot, and by repeated tearing away of the lining or membrane that covers the heel bone. These conditions may result from
biomechanical imbalance, running or jogging, improperly fitted or excessively worn shoes, or obesity. Plantar Fasciitis, both heel pain and heel spurs are frequently associated with plantar
fasciitis, an inflammation of 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. 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. 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 sense of relief. The pain often returns after prolonged rest or extensive walking. Heel pain sometimes results from excessive pronation. Pronation is the
normal flexible motion and flattening of the arch of the foot that allows it to adapt to ground surfaces and absorb shock in the normal walking pattern. As you walk, the heel contacts the ground
first; the weight shifts first to the outside of the foot, then moves toward the big toe. The arch rises, the foot generally rolls upward and outward, becoming rigid and stable in order to lift the
body and move it forward. Excessive pronation-excessive inward motion-can create an abnormal amount of stretching and pulling on the ligaments and tendons attaching to the bottom back of the heel
bone. Excessive pronation may also contribute to injury to the hip, knee, and lower back. Pain at the back of the heel is associated with Achilles tendinitis, which is inflammation of the Achilles
tendon as it runs behind the ankle and inserts on the back surface of the heel bone. It is common among people who run and walk a lot and have tight tendons. The condition occurs when the tendon is
strained over time, causing the fibers to tear or stretch along its length, or at its insertion on to the heel bone. This leads to inflammation, pain, and the possible growth of a bone spur on the
back of the heel bone. The inflammation is aggravated by the chronic irritation that sometimes accompanies an active lifestyle and certain activities that strain an already tight tendon. Other
possible causes of heel pain include rheumatoid arthritis and other forms of arthritis, including gout, which usually manifests itself in the big toe joint, an inflamed bursa (bursitis), a small,
irritated sac of fluid; a neuroma (a nerve growth); or other soft-tissue growth. Such heel pain may be associated with a heel spur or may mimic the pain of a heel spur. 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. This sometimes painful deformity generally is the result of bursitis caused by
pressure against the shoe and can be aggravated by the height or stitching of a heel counter of a particular shoe, a bone bruise or contusion, which is an inflammation of the tissues that cover the
heel bone. A bone bruise is a sharply painful injury caused by the direct impact of a hard object or surface on the foot.
Common symptoms, heel Spurs: the pain is usually worst on standing, particularly first thing in the morning when you get up. It is relatively common, though usually occurring in the over forty's age
group. There are no visible features on the heel but a deep localised painful spot can be found in or around the middle of the sole of the heel. Although it is often associated with a spur of bone
sticking out of the heel bone (heel spur syndrome), approximately ten per cent of the population have heel spurs without any pain. Heel Bursitis, pain can be felt at the back of the heel when the
ankle joint is moved and there may be a swelling on both sides of the Achilles tendon. Or you may feel pain deep inside the heel when it makes contact with the ground. Heel Bumps, recognised as firm
bumps on the back of the heel , they are often rubbed by shoes causing pain.
The diagnosis of heel pain and heel spurs is made by a through history of the course of the condition and by physical exam. Weight bearing x-rays are useful in determining if a heel spur is present
and to rule out rare causes of heel pain such as a stress fracture of the heel bone, the presence of bone tumors or evidence of soft tissue damage caused by certain connective tissue disorders.
Non Surgical Treatment
To properly treat heel pain, you must absorb shock, provide cushioning and elevate the heel to transfer pressure. This can be accomplished with a heel cup, visco heel cradle, or an orthotic designed
with materials that will absorb shock and shear forces. When the condition is pronation related (usually plantar fasciitis), an orthotic with medial posting and good arch support will control the
pronation and prevent the inflammation of the plantar fascia. Footwear selection is also an important criteria when treating heel pain. Shoes with a firm heel counter, good arch support, and
appropriate heel height are the ideal choice. If the problem persists, consult your foot doctor.
Surgery to correct heel pain is generally only recommended if orthotic treatment has failed. There are some exceptions to this course of treatment and it is up to you and your doctor to determine the
most appropriate course of treatment. Following surgical treatment to correct heel pain the patient will generally have to continue the use of orthotics. The surgery does not correct the cause of the
heel pain. The surgery will eliminate the pain but the process that caused the pain will continue without the use of orthotics. If orthotics have been prescribed prior to surgery they generally do
not have to be remade.
Wearing real good, supportive shoes are a great way to avoid heel pain. Usually, New Balance is a good shoe to wear, just for everyday shoe gear. By wearing proper footwear and performing thorough
stretches, athletes can help prevent frequent heel pain. If you are starting to get a little discomfort or pain in the feet or heel, know that pain is not normal. So if you are having pain, you
should be proactive and visit our office. If you let heel pain get out of control you could run into several other problems. It is always suggested to visit a podiatrist whenever you are experiencing