Heel pain is one of those conditions that all Podiatrists see regularly in their clinics. Anyone can suffer from heel pain, but certain groups seem to be at increased risk, including:
– Middle-aged men and women
– Physically active people
– People who are overweight or obese
– People who are on their feet for long periods of time
– Children aged between eight & 13 years (particularly boys)
– Women who are pregnant
For some patients, their pain resolves relatively quickly whilst others can experience the debilitating effects of heel pain longer.
What is the cause of heel pain?
Heel pain can be a result of numerous causes with patients usually reporting pain either underneath or just behind their heel. Of the 26 bones in our feet, our heel is the largest and designed to provide a rigid support for the weight of our bodies; absorbing up to 1.25 times our body weight when walking, even more with higher-impact activities like jumping and running. Consequently, it is vulnerable to damage and ultimately pain.
Below are just a few of the conditions that many of our patients present with to our clinics:
The plantar fascia is a band of connective tissue that travels along the sole from the heel to the ball of the foot. Plantar Fasciitis is a musculoskeletal condition causing pain under the heel or into the inner arch of the foot as a result of inflammation at the insertion point of the plantar fascia on the heel. The condition is due to mechanical over-stretching of the fibrous tissue in the arch. Most patients report pain with the initial few steps out of bed or after rest and returning towards the end of the day.
In many cases, plantar fasciitis is associated with a heel spur. During gait, abnormal mechanics can causes the insertion point of the plantar fascia to tear and bleed and, over time, these injuries calcify and form a bony growth.
It’s estimated that 1 in 10 people have a heel spur and may not present with any symptoms. During gait, excessive or abnormal mechanics can place extra strain on the plantar fascia. Chronic inflammation may develop and, over time, lead to a bony growth or spur. A spur can only be seen on x-ray, but its presence is often flagged by a tender patch at the heel on the sole of the foot. Displacement and loss of the fatty tissue under the heel can lead to the spur being more prominent. The spur itself does not cause the pain, but the pain may be associated with inflammation in the area.
A stress fracture of the calcaneus is a hairline fracture of the big heel bone and is usually caused by overuse from abnormal mechanics. Common in long distance runners, ballet dancers and sports involving jumping, a stress fracture of the calcaneus is the second most common stress fracture location in your foot. Symptoms of a calcaneal stress fracture may be similar to that of a bruised heel and pain will come on gradually over time and be made worse with weight bearing activity like running and jumping.
Achilles tendinopathy is a condition characterised by tissue damage and pain in the Achilles region and it is most commonly brought about through physical activity or a sudden change in the level of activity. Repetitive activity, trauma or high loads cause excessive tension to occur in the tissues damaging the tendon and causing subsequent inflammation and degeneration. As a result of the degeneration, the tissues within the tendon function abnormally and lose strength, contributing to further localised inflammation to occur, and can increase the risk of rupture with continued activity. Patients usually report pain and tenderness in their heel along with heel stiffness after rest and swelling.
Regardless of whether your heel pain is something new or something you have learnt to cope with, seeing our Podiatrists can help you identify the cause and establish a treatment plan to enable you to return to the activities you love – heel pain free!!!