What is Heel Pain
The heel bone 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 can occur in the front, back, or bottom of the heel, which can sometimes be disabling.
Heel pain has many causes. 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, wearing poorly constructed footwear (such as flimsy flip-flops), being overweight, or a bruise incurred while walking, running, or jumping on hard surfaces.
Some common causes of heel pain include:
- Heel spurs – a bony growth on the underside of the heel bone. 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.
- 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.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
- 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.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. It may also contribute to injury to the hip, knee, and lower back.
- Achilles Tendinitis — inflammation of the Achilles tendon as it runs behind the ankle and inserts on the back surface of the heel bone. 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.
When to See Your Podiatrist
If pain and other symptoms of inflammation—redness, swelling, heat—persist, limit normal daily activities and contact our office immediately.Early treatment might involve oral or injectable anti-inflammatory medication, exercise and shoe recommendations, or use of shoe inserts or orthotic devices. Physical therapy may be used in conjunction with such treatments.
A 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. Only a relatively few cases of heel pain require more advanced treatments or surgery.