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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; or being overweight.
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, sometimes disabling, can occur in the front, back, or bottom of the heel.
Prevention
A variety of steps can be taken to avoid heel pain and accompanying afflictions:
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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.
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Treatment
If pain and other symptoms of inflammation-redness, swelling, heat-persist, you should limit
normal daily activities and contact a doctor of podiatric medicine.
The podiatric physician 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 functional
orthotic device may be prescribed for correcting biomechanical imbalance, controlling excessive pronation, and supporting of 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. If surgery
is necessary, it may involve the release of the
plantar fascia,
removal of a spur, removal of a
bursa, or removal of a neuroma or other soft-tissue growth.
more information and photographs
You can also download our Podiatry-at-a-Glance newsletter:
A Guide to Heel Pain (Heel Spur Syndrome)
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(content courtesy of APMA)
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