Causes of Heel Pain
Heel pain is one the most common problems seen by Canadian Certified Pedorthists. Causes include:
- Poor foot mechanics
- Being overweight
- Low activity levels
- Improper footwear
- Unfavourable ground conditions
Common heel conditions include:
One of the most common heel problems seen by Canadian Certified Pedorthists, plantar fasciitis is the inflammation and irritation of the plantar fascia (a thick fibrous tissue that extends from the heel to the toes, supporting the arch). Poor foot posture or excessive ankle motion during walking can strain the plantar fascia resulting in small tears and increased tension where the fascia attaches to the calcaneus (heel).
- Pain and swelling (inflammation) at the beginning of the arch or bottom of the heel
- Often the pain is worse with the first few steps after rising in the morning or after sitting
Calcaneal Stress Fracture
Calcaneal stress fracture of the heel is usually a result of some sort of trauma but can also result from increased activity done improperly.
- Total avoidance of weight-bearing
Retrocalcaneal Bursitis (Achilles bursitis)
Retrocalcaneal bursitis is the inflammation of the bursa (balloon-like lubricating sack) that lies between the Achilles tendon and the back of the heel bone (calcaneus).
- Tenderness at the back of the heel just above where the Achilles tendon attaches
- Swelling of the bursa produces symmetric widening of the heel where the Achilles tendon attaches to the calcaneus (heel)
- Pain increases with passive dorsiflexion (bending the foot towards the front of the leg) of the ankle or when standing on toes
Achilles tendonopathy is an injury to the Achilles tendon just above the heel on the back of the leg. This condition may be due to abnormal or excessive strain on the tendon from poor shock absorption or excessive foot pronation.
- Pain, swelling, and possible nodule formation along the Achilles tendon or where it is attached to the back of the calcaneus (heel)
- Stiffness may be present after sitting or resting
- Foot and lower limb exam
- Custom-made foot orthotic or over-the-counter device
- Recommendation of appropriate and proper-fitting footwear
- Modification of footwear
To prevent and alleviate heel pain, Canadian Certified Pedorthists recommend:
- Carefully and slowly increasing activity to allow the tissues of the lower limbs time to properly adapt
- Wearing stable shoes with sturdy heel counters (the back of the shoe) to control motion and provide shock absorption
- When injury does occur, consult a Canadian Certified Pedorthist to determine if an over-the-counter device or a custom-made foot orthotic, along with appropriate footwear, will help the healing process and prevent the recurrence of problems
- Avoid going barefoot or just wearing socks while injured as poor foot mechanics can aggravate the injury further if not controlled
- Icing and simple calf stretching can help alleviate pain associated with heel pain. Patients should ice the affected area for approximately eight minutes, three times a day.
If you are experiencing foot pain or discomfort, you should talk to your doctor or book an appointment with a Canadian Certified Pedorthist directly for pedorthic management including orthopaedic footwear, shoe selection guidance and orthotics.