Heel Soreness

Overview

Heel Discomfort

Millions of people each year suffer from heel pain. Many of those don?t understand heel pain causes and will often not seek proper Heel Pain treatment. Heel pain is often directly related to plantar fasciitis. Plantar fasciitis is an inflammation of the plantar fascia that, when addressed early, can be easily treated.

Causes

To understand the cause of the pain one must understand the anatomy of the foot and some basic mechanics in the function of the foot. A thick ligament, called the plantar fascia, is attached into the bottom of the heel and fans out into the ball of the foot, attaching into the base of the toes. The plantar fascia is made of dense, fibrous connective tissue that will stretch very little. It acts something like a shock absorber. As the foot impacts the ground with each step, it flattens out lengthening the foot. This action pulls on the plantar fascia, which stretches slightly. When the heel comes off the ground the tension on the ligament is released. Anything that causes the foot to flatten excessively will cause the plantar fascia to stretch greater that it is accustom to doing. One consequence of this is the development of small tears where the ligament attaches into the heel bone. When these small tears occur, a very small amount of bleeding occurs and the tension of the plantar fascia on the heel bone produces a spur on the bottom of the heel to form. Pain experienced in the bottom of the heel is not produced by the presence of the spur. The pain is due to excessive tension of the plantar fascia as it tears from its attachment into the heel bone. Heel spur formation is secondary to the excessive pull of the plantar fascia where it attaches to the heel bone. Many people have heel spurs at the attachment of the plantar fascia with out having any symptoms or pain. There are some less common causes of heel pain but they are relatively uncommon. There are several factors that cause the foot to flatten and excessively stretching the plantar fascia. The primary factor is the structure of a joint complex below the ankle joint, called the subtalar joint. The movement of this joint complex causes the arch of the foot to flatten and to heighten. Flattening of the arch of the foot is termed pronation and heightening of the arch is called supination. If there is excessive pronation of the foot during walking and standing, the plantar fascia is strained. Over time, this will cause a weakening of the ligament where it attaches into the heel bone, causing pain. When a person is at rest and off of their feet, the plantar fascia attempts to mend itself. Then, with the first few steps the fascia re-tears causing pain. Generally, after the first few steps the pain diminishes. This is why the heel pain tends to be worse the first few steps in the morning or after rest. Another factor that contributes to the flattening of the arch of the foot is tightness of the calf muscles. The calf muscle attaches into the foot by the achilles tendon into the back of the heel. When the calf muscle is tight it limits the movement of the ankle joint. When ankle joint motion is limited by the tightness of the calf muscle it forces the subtalar joint to pronate excessively. Excessive subtalar joint pronation can cause several different problems to occur in the foot. In this instance, it results in excessive tension of the plantar fascia. Tightness of the calf muscles can be a result of several different factors. Exercise, such as walking or jogging will cause the calf muscle to tighten. Inactivity or prolonged rest will also cause the calf muscle to tighten. Women who wear high heels and men who wear western style cowboy boots will, over time, develop tightness in the calf muscles.

Symptoms

See your doctor immediately if you have Severe pain and swelling near your heel. Inability to bend your foot downward, rise on your toes or walk normally. Heel pain with fever, numbness or tingling in your heel. Severe heel pain immediately after an injury. Schedule an office visit if you have. Heel pain that continues when you’re not walking or standing. Heel pain that lasts more than a few weeks, even after you’ve tried rest, ice and other home treatments.

Diagnosis

Depending on the condition, the cause of heel pain is diagnosed using a number of tests, including medical history, physical examination, including examination of joints and muscles of the foot and leg, X-rays.

Non Surgical Treatment

Curing posterior heel pain requires calming the inflammation, resting the foot and increasing calf flexibility. Ice therapy and anti-inflammatory medications can be used to reduce the inflammation. Stopping exercises that stress the calf and Achilles is important. This includes walking, running and the use of stair climbers and elliptical machines. Placing a heel lift in each shoe can reduce some of the excess strain on the back of the heel. Stretching exercises to increase calf flexibility are important in curing this problem and preventing its recurrence. Wearing running shoes also provides good foot support and helps with this condition. Sometimes a walking boot is used to immobilize the ankle and let the area completely rest. Physical therapy is sometimes ordered to help reduce the inflammation and pain and to help improve the flexibility of the calf muscles. Occasionally these measures fail to relieve the pain and surgery may be needed. The surgical procedure involves removing bone spurs and repairing any damage to the tendon.

Surgical Treatment

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.

Prevention

Painful Heel

The following steps will help prevent plantar fasciitis or help keep the condition from getting worse if you already have it. The primary treatment is rest. Cold packs application to the area for 20 minutes several times a day or after activities give some relief. Over-the-counter pain medications can help manage the pain, consult your healthcare professional. Shoes should be well cushioned, especially in the midsole area, and should have the appropriate arch support. Some will benefit from an orthotic shoe insert, such as a rubber heel pad for cushioning. Orthotics should be used in both shoes, even if only one foot hurts. Going barefoot or wearing slipper puts stress on your feet. Put on supportive shoes as soon as you get out of bed. Calf stretches and stretches using a towel (place the towel under the ball of your feet and pull gently the towel toward you and hold a few seconds) several times a day, especially when first getting up in the morning. Stretching the Achilles tendon at the back of the heel is especially important before sports, but it is helpful for nonathletes as well. Increasing your exercise levels gradually. Staying at a healthy weight. Surgery is very rarely required.

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What Causes Heel Pain?

Indiana Podiatry Group has been serving the residents of central Indiana for nearly twenty years. The doctors have dedicated themselves to providing their patients with the most comprehensive and compassionate foot and ankle care in the area. They use advanced medical and surgical techniques to treat all conditions of the foot and ankle. Each office is well equipped with radiology services, vascular testing equipment, wound care supplies, durable medical equipment, medical products, and suites for minor surgical procedures. Heel pain is a common complaint. Although many conditions can cause heel pain, some of the more common causes are exercise-related injuries and/or genetics. Following are some common causes of heel pain.

This time, using those muscles in your right arm, Do Not Let Your Right Wrist Bend any more than it already has. Then, with your left hand, press on the back of your right hand again, trying to bend your right wrist. As long as you do not let your right wrist bend, you will find that it does NOT hurt, no matter how hard you push with your left hand. You can now relax and I will tell you the theory of what is happening. Your protocol for treating Sever’s disease has been a miracle for our one daughter. I am so very thankful!! ~ Ashley Ankle Injury

Galloway, a runner himself, lists several cheap methods to reduce heel pain caused by plantar fasciitis. First, get plent of rest, and never go barefoot. Even when first getting out of bed, wear supportive footwear. (Flip-flops and slippers don’t count.) Rolling a golf ball under your arch can help loosen the tissue and curling your toes repetitively can help strengthen the region. Freeze a bottle of water and roll it under the arch after running to prevent new inflammation. If these simple tips don’t help, make an appointment with your doctor or physical therapist.

Try this workout to develop strength and include flexibility to your feet. While sitting with your feet flat on the floor, raise your heels and hold for 5 seconds. Next, press your toes to the floor for another five seconds. Do this regular 10 times. Are we becoming too dependent upon doctors for OUR wellness? The statistics state ‘yes’ and regrettably billions of dollars are gotten rid of each year due to the fact that of this! Cure your gout naturally with a house solution that will say you hundreds of dollars! Treat your gout today!

Sometimes, muscle strain and tension pull at the origin site on the bottom surface of the heel bone producing an inflammatory response that begins making new bone. This interim condition is called periostitis The forming bone spur grows forward in the direction of this pulling. Heel spurs can irritate nerves and cause pain. Side View of Foot Back View of Foot Muscles Click on the images to view a larger version. Incidence and Prevalence of Heel Pain Most importantly the Podiatrist can make sure that it is Fasciitis and not some other condition that mimics the symptoms and may be more serious.heel pain

Bruised heels are very painful. It usually happens because of bony projections on the bottom of the heel bone. There are similar diseases to bruised heels such as plantar calcaneal bursitis and plantar fasciitis. They all cause pain in the heels, but they are different from bruised heels. To prevent cramps from occurring, you should warm up and stretch your muscles sufficiently; especially before any prolonged activity. This is very important because cold muscles are more vulnerable to injuries than warmed ones. Keep yourself hydrated most of the time and wear well-fitted orthotics provided by DocPods; they help support your feet throughout the day.

Another type of foot orthotic is known as “customised” rather than “custom.” These devices can be difficult to distinguish from custom foot orthotics and, unfortunately, are sometimes marketed as authentic custom foot orthotics. They are often the product of a computerized system where the client is asked to walk across a force plate which then shows pressure distribution on a computer display which only measures a 2-dimensional pressure. There is no way to produce an accurate 3D orthotic using this method. Typically, the orthotic is made by adding extra components to a pre-manufactured insole. Sadly, clients are often told that these are custom – and charged a custom orthotic price.

Everyone has unique desires. If you feel you need to see a doctor about your concerns related to arthritis or pain in your legs or feet, please do. Sneakers come in dissimilar widths. When you get measured at a store, your width will be determined as well. We are inclined to go up a size providing a sneaker is tight fitting on the sides. Providing this is happening then you will simply need a wider shoe. Widths stretch beginning with extremely small such as AA and exceptionally wide like as EEE. For women, regular width is a B. For men the standard width is a D.

Therefore, patients that suffer from heel pain must undergo both aspects of the treatment – pain relief and relapse prevention. Much like it doesn’t make sense to buy new tires and not have them aligned, heel pain relief will only be temporary unless the biomechanics of the foot are addressed. That’s why it is important to see a sports medicine specialist that is knowledgeable in lower extremity biomechanics to get the most comprehensive treatment available for heel pain About the Author Heel spur is the outgrowth of the bone of the heel. It may be located at the back of the heel or beneath the sole of the feet.

Bekelman said a large clinical trial in 2005 concluded that the two regimens provide equal pain control with similar side effects. Some say patients are more likely to require a second round of treatment with single-fraction therapy, but Bekelman said evidence was mounting that the two forms of treatment are equal, even when it comes to retreatment. The American Society for Radiation Oncology (ASTRO) 2011 guidelines favored a single treatment, he said. ASTRO and the American Academy of Hospice and Palliative Medicine include multiple-fraction radiation in lists of potentially unnecessary treatments doctors and patients should discuss.