Heel pain is one of the most common conditions treated by podiatrists. It is often a message that something is in need of medical attention. Pain that occurs right after an injury or early in an illness may play a protective role, often warning us about the damage we have suffered. Heel pain is a problem which affects people of all ages and vocations, whether they are active or not and it comes in many different forms. Heel pain can also occur in children usually between the ages of 8 and 13, as they become increasingly active in sporting activities and during the growing phase.
There are two different categories of heel pain. The first is caused by over-use repetitive stress which refers to a soreness resulting from too much impact on a specific area of the foot. This condition, often referred to as "heel pain syndrome," can be caused by shoes with heels that are too low, a thinned out fat pad in the heel area, or from a sudden increase in activity. Plantar fasciitis, a very common diagnosis of heel pain, is usually caused from a biomechancial problem, such as over-pronation (flat feet). The plantar fascia is a broad band of fibrous tissue that runs along the bottom surface of the foot, from the heel through the midfoot and into the forefoot. Over-pronation can cause the plantar fascia to be excessively stretched and inflamed, resulting in pain in the heel and arch areas of the foot. Often the pain will be most intense first thing in the morning or after a prolonged period of rest. The pain will gradually subside as the day progresses.
The most common complaint is pain and stiffness in the bottom of the heel. Heel pain may be sharp or dull, and it may develop slowly over time or suddenly after intense activity. The pain is typically worse in the morning, when taking your first steps of the day. After standing or sitting for a while. When climbing stairs.
A biomechanical exam by your podiatrist will help reveal these abnormalities and in turn resolve the cause of plantar fasciitis. By addressing this cause, the patient can be offered a podiatric long-term solution to his problem.
Non Surgical Treatment
Morning Wall Stretch. Stand barefoot in front of wall, as shown. Press into wall with both hands and lean forward, feeling stretch along back of left leg and heel. Hold for 30 seconds; switch sides and repeat. Freeze and Roll. Freeze a small water bottle. Cover it with a towel and place arch of your foot on top of it. Slowly roll bottle beneath arch of foot for about 5 minutes at a time. Switch sides and repeat. Rub It Out. Use both thumbs to apply deep pressure along arch of the feet, heel, and calf muscles, moving slowly and evenly. Continue for 1 minute. Switch sides and repeat. If you foot pain isn't improving or worsens after 2 weeks, a podiatrist or othopedist can prescribe additional therapies to alleviate discomfort and prevent recurrence.
If treatment hasn't worked and you still have painful symptoms after a year, your GP may refer you to either an orthopaedic surgeon, a surgeon who specialises in surgery that involves bones, muscles and joints or a podiatric surgeon, a podiatrist who specialises in foot surgery. Surgery is sometimes recommended for professional athletes and other sportspeople whose heel pain is adversely affecting their career. Plantar release surgery is the most widely used type of surgery for heel pain. The surgeon will cut the fascia to release it from your heel bone and reduce the tension in your plantar fascia. This should reduce any inflammation and relieve your painful symptoms. Surgery can be performed either as open surgery, where the section of the plantar fascia is released by making a cut into your heel or endoscopic or minimal incision surgery - where a smaller incision is made and special instruments are inserted through the incision to gain access to the plantar fascia. Endoscopic or minimal incision surgery has a quicker recovery time, so you will be able to walk normally much sooner (almost immediately), compared with two to three weeks for open surgery. A disadvantage of endoscopic surgery is that it requires both a specially trained surgical team and specialised equipment, so you may have to wait longer for treatment than if you were to choose open surgery. Endoscopic surgery also carries a higher risk of damaging nearby nerves, which could result in symptoms such as numbness, tingling or some loss of movement in your foot. As with all surgery, plantar release carries the risk of causing complications such as infection, nerve damage and a worsening of your symptoms after surgery (although this is rare). You should discuss the advantages and disadvantages of both techniques with your surgical team.
heel pad anatomy
Prevention of heel pain involves reducing the stress on that part of the body. Tips include. Barefeet, when on hard ground make sure you are wearing shoes. Bodyweight, if you are overweight there is more stress on the heels when you walk or run. Try to lose weight. Footwear, footwear that has material which can absorb some of the stress placed on the heel may help protect it. Examples include heel pads. Make sure your shoes fit properly and do not have worn down heels or soles. If you notice a link between a particular pair of shoes and heel pain, stop wearing them. Rest, if you are especially susceptible to heel pain, try to spend more time resting and less time on your feet. It is best to discuss this point with a specialized health care professional. Sports, warm up properly before engaging in activities that may place lots of stress on the heels. Make sure you have proper sports shoes for your task.