Heel pain affects a large portion of the population, often resulting in visits to The Podiatrist. Plantar fasciitis is typically the diagnosis the patient receives during the visit; however, plantar fasciitis is only one potential cause of heel pain. The plantar fascia is a strong, dense strip of tissue that runs from the heel to the ball of the foot. Its sole job is to support the arch of the foot. .
It is easy to see how the plantar fascia may be causing all this pain as the foot impacts the ground when you think about how often the full weight of the body is concentrated on the plantar fascia. This forces it to stretch as the arch of the foot flattens from the full weight of the body, possibly leading to stress where the plantar fascia attaches at the heel bone. If this keeps up, the result can be pain caused by small tears of the fascia.
If it is not the plantar fascia then what else could be causing my heel pain?
Calf muscle weakness (muscles on the back of the lower leg) can result in referred pain directly to the heel.This is seen after someone has changed/added a workout program or modified the type of shoes they wear. This adds additional stress to the calf muscles that they may not have been ready for and lead small areas of irritation in the muscles.>
Calf muscle tightness – this causes the connective tissue surrounding the muscle to pull harder on the Achilles tendon leading to tightness at the heel, possibly resulting in the pain you’re feeling.
Sciatic nerve irritation – the nerve that runs from the low back through the hip and down the leg to the foot can get tight or pinched not allowing the nerve to move easily as you walk. This can lead to irritation of the nerve causing pain that is located at the heel. This is very common for anyone with any history of low back pain or hip pain.
Poor Posture – if you sit slumped forward most of the day the muscles and structures from the back of your neck, upper back, lower back, and hips can get tight and shortened, consequently pulling on the heel.>
Weakness of the muscles around the hip can cause muscles in the leg to shorten to help stabilize, consequently pulling on the heel.>
Why is this so confusing?
It may be hard for you to pinpoint the cause of heel pain yourself because the symptoms are the same for all of the above listed causes. No matter what the cause, you will experience pain on or around the heel when weight is placed on the foot. This is usually worse in the morning, especially with the first few steps after getting out of bed. In most cases, there is no pain at night, but this is not a rule as many of our patients report increased pain at night. Pain of typical plantar fasciitis is typically believed to decrease over the course of the day as the tissue warms up; however, patients have also reported increased discomfort as the day progresses, leading on to investigate other areas as the source or cause. Additionally, prolonged standing, walking, or getting up after long periods of sitting are commonly reported with all of the above causes. Again, the reports can be as varied as the potential causes.
Activities that make the pain worse:
Excessive running or jumping
Changing physical activity (especially for athletes)
High arches, flat feet, abnormal gait
Wearing improper shoes while walking or running
The Steps to Relieve Heel Pain
In most cases, heel pain does not require surgery and can be treated conservatively, but the first step is to obtain an evaluation by The Podiatrist who can help pin point the actual cause of the pain that’s specific to you. It is important to not treat the symptom of heel pain, but to isolate and treat the cause.
The Podiatrist may then recommend treatment , depending on the needs of your particular condition. In extremely painful conditions, your doctor may prescribe anti-inflammatory medications, and in severe cases give you a cortisone shot to address excessive inflammation.
Most people with heel pain get better with the help of The Podiatrist, but don’t wait. The longer you “live” with the pain the longer it may take to get rid of it as your body adapts. Most acute cases (less than 30 days) can get better within 6-8 weeks. Additionally, treatment should include activities that directly address the cause of your heel pain and are designed to include you in the healing process, so your participation is critical.
The Podiatrist specializes in the treatment and management of all foot related problems and will assess what is the cause of your foot/heel pain, not the symptom.
For more information or to find out if you are a good candidate for our services contact The Podiatrist
Nobody loves their jandals more than us Kiwis. As the warmer weather approaches (we hope), we start digging out the jandals.
They’re so easy and breezy, such an obvious choice, especially when summer reaches its peak and the holidays are in full swing.
But the next time you reach into the closet and pull out your favorite pair, be aware: You could be opening a Pandora’s box of podiatry problems.
Your favorite sassy and affordable flats are an unstable form of footwear, known to wreak havoc on arches, heels and toes, says The Podiatrist.
It’s a disaster waiting to happen. And sure, many people make it through just fine. But the shoes are a problem.
Here are the of wearing the favourite Kiwi fashion accessory and the risks and some tips
Tension for the toes: Wearing jandals may feel like the next-best thing to going barefoot, but your feet are working harder than you think. Jandals force a change in your walking stride. With each step, the toes pull down on the shoe to stabilize the foot against the ground. Your foot has to step forward a little quicker. It’s trying to keep the flip-flop on. The result, is toe pain and stubbed toes.
Bound for blisters: The classic jandal features two straps sprouting from between the first two toes. Everyone dislikes how the rubbing triggers blisters. Problem is, there’s no other place for toes to hang on to the sandal.
Arch of no triumph: Spend too much time walking in jandals, and the muscles that hold up the foot’s arch start to fatigue. Arch pain comes when those muscles change the way they function just to keep you moving along. Runners, hyper-fast walkers and heavier folks will feel this more often.
Plant this: About 15 percent of all adult foot injuries involve plantar fasciitis, that awful pain that comes from the tissue stretching from your heel, through the arch to the toes. It’s impossible to ban jandals, especially in the tropical environment, so if you’re going to the beach, wear your jandals, but don’t take your four kilometre morning walk in jandals. Don’t walk around the Malls doing Christmas shopping in jandals, and don’t go sight seeing on holiday and walk around all day in jandals, because you’re just looking for trouble.
Fractured feet: Stress fractures, often on the top of the foot ,typically don’t come from an injury, but from normal activity. With a stress fracture, you might as well trade in your jandals for an immobilizing foot boot.
Domino effect: One andals injury can lead to more problems, he says. You start walking differently and then your ankle hurts, your knee hurts, your back hurts. It works its way up. People with existing chronic health problems can unknowingly put themselves at risk, too. Anyone with balance problems or foot instability should not consider jandals. Those with diabetes or circulation problems should be careful, as foot punctures and extreme pressure on the balls of your foot can lead to blisters and ulcers.
Hot foot: Everyone has, at one time or another, forgotten to put sunscreen on the top of their jandaled feet. The resulting sunburn is painful enough, but those blisters can evolve into even more serious problems.
Be cautious: Jandals are not the proper footwear for yard work or backyard play. The Podiatrist urges common sense. If you’re mowing, pulling weeds are using a shovel, pull on a sturdy pair of shoes. If you’re getting ready to play catch, touch football or horseshoes, grab your sneakers. You can slip back into your jandals when you’re done.
For all your footcare needs and advice- visit The Podiatrist
Children are resilient, but when your child begins to complain about heel pain, this must be taken seriously. Heel pain in a child is not normal. There are different causes of heel pain in a child and an adequate physical exam can help determine which type of heel pain is affecting your child.
What Is Calcaneal Apophysitis?
The most common cause of pediatric heel pain is calcaneal apophysitis (an injury or irritation to the growth plate of the heel). Typically, this occurs in boys (and girs) between the ages of 8 and 13 who are fairly active children. This is most likely to occur with a rapid increase in activity after a period of rest – such as starting rugby, soccer, netball and any in fact and sport practice after being off for a peiod of time.
Are There Other Causes of Pediatric Heel Pain?
Yes. Calcaneal apophysitis is the most common cause of pediatric heel pain. However, there are other things that can cause the heels to hurt such as stress fractures, growth plate fractures and hematagenous osteomyelitis, an infection of the heel bone.
Causes of Calcaneal Apophysitis
Causes of pediatric heel pain include:
- Rapid increase in physical activity (sports)
- Changes in training surfaces
- Changes in training techniques
- Changes in shoe gear (or going barefoot) while being physically active
- A rapid increase in growth over a short period of time
During periods of rapid growth, the bones of the leg grow faster than the soft tissues (muscles, tendons and ligaments) and the stress they place across the growth plate can cause pain and inflammation.
Symptoms of Calcaneal Apophysitis
Calcaneal apophysitis typically affects active boys and girls between the ages of 8 and 13; however, this condition can affect any active child. Early signs and symptoms include:
- Inability to participate in athletic activities
- Walking on the toes to keep the heel from touching the ground
- Pain in the heel that is worse after activity and relieved by resting
The Podiatrist will start your exam with a thorough history. This will be followed by a physical exam. During your physical exam, The Podiatrist:
- Pain and tenderness to the area of the inflamed growth plate
- A tight heel cord (Achilles tendon)
- Overall foot structure
- Abnormalities in gait
X-rays may be ordered to detect any underlying bone abnormalities.
Calcaneal apophysitis can be easily treated with changes in shoe gear, resting, icing, stretching and anti-inflammatory medications. Sometimes, physical therapy may be necessary, but this is rare.
Many times these types of injuries are unavoidable, but proper athletic shoes, stretching exercises and avoidance of obesity are some of the ways one can prevent an injury to the growth plate.
See The Podiatrist for expert care.
Nowadays, most Podiatists and Doctors would agree that heel pain is a very common malady. However, there are many causes of this pain. One of the most prevalent is the heel spur. A heel spur results from an anatomical change of the heel bone.
What are Heel Spurs?
The heel bone forms one end of the two longitudinal arches of the foot held in place by ligaments and are activated by the muscles of the foot. These muscles and ligaments, like the other supporting tissues of the body, are attached in two places. Where there is undue stress to the heel bone, one’s body automatically calcifies the tissue attachments thus creating a spur.
The pain from heel spurs is a result of inflammation around the tendons where they attach to the heel bone. Most would assume that the pain would dramatically increase as you walk but it is not usually the case. In all actuality, the pain is the most intense when you begin to walk after not being on your feet for a while. After a short period of time, the pain usually dissipates and you adjust.
If excessive strain has been placed on the foot the day before, the pain may also be greater. A sudden strain, as might be produced by leaping or jumping, can also increase the pain. The pain might be localized at first, but continued walking and standing after being stressed will soon cause the entire heel to become tender and painful.
It has been reported that anywhere between 11 and 27% of the population have radiographic evidence of a spur. Furthermore, heel spurs do appear to be associated with obesity, osteoarthritis and a major component of the aging process.
Heal Heel Spurs
To help alleviate the pain, see The Podiatrist to have the condition diagnosed.
Have you experienced heel spurs before? What do you do to alleviate the pain from heel spurs?
See The Podiatrist if you are experiencing problems.