Heel Pain

Heel pain is the most common foot complaint in the UK. It is the largest bone in your foot and localised pain in this area can feel more intense than in other areas of the foot. Thousands of people throughout the UK experience the sharp, stabbing pain in the heel, usually first thing in the morning or after long periods of inactivity.

The heel is the part of the body that endures the impact of walking or physical activity. For all other body parts, walking might be a form of “low-impact” exercise but the heel still has to absorb the impact of your body weight as your feet carry you.

 

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What Causes Heel Pain?

Heel pain can be experienced on the underside of the heel and the arch of the foot. This kind of heel pain is actually called Plantar Fasciitis and is manageable with orthotics or supportive shoe inserts. Plantar Fasciitis is the most common kind of heel pain and cause of heel spurs. The plantar fascia is the band of fibrous tissue which connects the heel bone to the toe bones. Its function is to support the arch of your foot. A normal fascia tendon is strong and flexible but abnormal stress, excessive weight, age and poor foot function can cause micro-tears which will lead to irritation and inflammation at the attachment of the plantar fascia into the calcaneus (heel bone).

During rest (e.g. when you're asleep or long periods of inactivity), this muscle tightens and shortens.

When body weight is rapidly applied to the foot, the fascia must stretch and quickly lengthen, causing micro-tears in the fascia. Hence, the stabbing heel pain with your first steps in the morning. After a little bit of walking the stabbing heel pain usually subsides.

A more temporary cause for heel pain is a sprain or strain as a result of physical activity. Plantar Fasciitis is a kind of sprain (as it overstretches the tissue that runs from the heel to the toe bones), but sport-related sprains are often more temporary. You can experience this temporary heel pain as a result of carrying something heavy, slipping and falling or a prolonged time in a non-optimal position.

Why Heel Pain Occurs:

  • You suffer from over-pronation (lowering of the arches)
  • You are over 50 years of age
  • You are overweight or pregnant
  • You stand or walk on hard surfaces for long periods
  • You do a lot of running and/or sports
  • You have tight calf muscles

Other less common causes of heel pain may include:

Bursitis - This is the inflammation of the small, fluid filled sacs (Bursa) which are found between tendons and bones.

Fat Pad Atrophy - This is where the fat pad under the heel is damaged due to too much strain.  Women who wear high heels a lot are more prone to this.

Sever's Disease - This is more common in children.  It is caused by the tightening and lengthening of muscles and tendons due to growth spurts.

Tarsal Tunnel Syndrome - There is a small "tunnel" by the ankle joint which the nerves for the foot pass through.  If this is damaged, then the nerves are compressed, and this can result in pain along the foot including under the heel.

How To Care For Heel Pain

As the most common form of heel pain, strains such as Plantar Fasciitis can largely be treated at home. Treatment for heel pain is focused on preventative measures and pain management, including the following:

Pain Relief – Over the counter anti-inflammatory medication, such as ibroprofen, will temporarily manage the pain if you are experiencing acute heel pain or the stabbing sensation is prolonged.

Supportive Footwear – FootActive orthotic inserts are designed by Podiatrists and are NHS recommended for providing effective heel pain relief. These insoles will support the longitudinal arch and the transverse arch with cushioning for shock absorption. The insoles will raise the heel and reduce the stress on the tendon. This is a low-cost and efficient way to combat heel pain, as it does not interrupt your daily routine or prevent you from enjoying physical activity. Plantar Fascia insoles also help with other foot health concerns and are a long-term solution for heel pain. 

Ice & Rest Rotations – This easy cure-all method will reduce the swelling or inflammation of heel pain. It is a more temporary-solution, but if you find your heel pain only occurs after a long-day on your feet, you might find this method beneficial. If you feel the need to use this form of heel pain treatment regularly, it is advised that you consider long-term solutions, such as insoles or consult your podiatrist.

Physical Therapy – You can complete courses or watch videos of physical conditioning that strengthen the tendon and muscles in your feet, reducing your heel pain. Exercises will focus on the Plantar Fascia, Achilles tendon and lower leg muscles (soleus & gastrocnemius).

Medical Intervention – Sometimes, if the pain persists and becomes acute enough that it stops you from working and minimises your movement, your doctor may decide to use steroid injections for pain relief. This will only be an option in very serious (and very few) cases as it risks rupturing the tendon.

As a last resort, your doctor may decide to surgically separate the plantar fascia from the heel bone.

For more information on managing and preventing heel pain, contact the experts at FootActive. We will also be able to advise on the most effective and useful orthotic insert to combat your unique foot pain.

 

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