Heel pain, particularly plantar heel pain, is a common complaint among many individuals. But what exactly causes this discomfort, and how can it be addressed? Let’s delve into the topic.
What is Plantar Heel Pain?
Plantar heel pain is a type of discomfort that occurs at the bottom of the heel. It’s often most pronounced during the first steps in the morning or after prolonged rest periods.
What Does It Feel Like?
Patients with plantar fasciitis typically experience discomfort beneath the ball of the heel, and this pain has been compared to having a stone bruise. Arch discomfort is a symptom of the illness that occurs less frequently but is nevertheless essential.
It is typical to have discomfort in the heel while getting out of bed first thing in the morning or after periods of relaxation, such as after driving or sitting for an extended amount of time. Pain in the heel can be unpredictable, and the affected individual can frequently experience pain-free intervals during which they believe they are progressing towards recovery.
It’s possible that you tore your plantar fascia if the discomfort started suddenly instead of gradually worsening over time. This happens more often than you may think.
Common Causes of Plantar Heel Pain
- Poor Foot Biomechanics: An abnormal gait pattern or structural foot abnormalities can lead to undue stress on the heel.
- Excessive Pressure: This can be due to being overweight or activities that put a lot of strain on the feet.
- Injury and Trauma: Accidents or injuries can directly impact the heel, leading to pain.
- Limited Ankle Movement: Restricted dorsiflexion can put extra strain on the plantar fascia.
- Foot Strength Deficits: Weak foot muscles can contribute to the onset of heel pain.
- Overtraining: Athletes, especially runners, can experience heel pain if they push themselves too hard or don’t allow adequate recovery time.
- Training Surfaces: Uneven or hard terrains can increase the risk of heel pain.
- Inappropriate Footwear: Shoes that don’t offer proper support or are worn out can exacerbate heel issues.
- Muscle Tightness: Overused or tight calf muscles can pull on the heel bone.
- Systemic Diseases: Conditions like reactive arthritis can manifest as heel pain.
- High BMI: Being overweight can put additional pressure on the feet, leading to discomfort.
It is essential for the podiatrist to make a distinction between typical plantar fasciitis and plantar fascia tears since the therapy for each condition is different. Your podiatrist will also be able to rule out the chance of you having a stress fracture, which is another condition that may occasionally cause symptoms that are quite similar.
Imaging using ultrasound could be required to accurately diagnose why the patient is experiencing discomfort in their heels.
Our podiatrists at Well Heeled Podiatry have an extensive amount of experience as well as a high level of expertise in the diagnosis and treatment of heel pain.
Who Suffers From Heel Pain?
Heel pain is not exclusive to any particular group of people; it can affect anyone, regardless of age, gender, or lifestyle. However, certain individuals may be more prone to experiencing this discomfort due to various factors:
- Athletes and Runners: Those who engage in high-impact sports or activities that put repetitive stress on the heel, such as running or jumping, are at a higher risk.
- Overweight Individuals: Carrying extra weight can exert additional pressure on the feet, especially the heels, making overweight and obese individuals more susceptible.
- Pregnant Women: The weight gain and hormonal changes during pregnancy can lead to foot issues, including heel pain.
- Elderly: The natural padding on the heel thins out with age, making the elderly more prone to heel discomfort.
- People with Flat Feet or High Arches: Abnormal foot structures can lead to uneven weight distribution, causing strain on the heel.
- Professionals on Their Feet: Individuals who spend long hours standing or walking, such as nurses, teachers, and factory workers, often report heel pain.
- Individuals with Tight Achilles Tendons: A tight Achilles tendon can exert more pressure on the heel, leading to pain.
- People Wearing Ill-fitting Shoes: Shoes lacking proper support or tightness can contribute to heel discomfort.
Understanding the groups more prone to heel pain can help in early diagnosis and timely intervention. If you belong to any of these categories and experience heel discomfort, seeking advice and treatment promptly is crucial.
Additional Key Points
1. Plantar Fasciitis
One of the most common causes of soreness in the heel is due to this condition. Plantar fasciitis is an inflammation of the thick band of tissue that extends from the heel bone all the way down to the toes and is known as the plantar fascia.
- Symptoms: The condition typically causes a stabbing pain that usually occurs with your very first steps in the morning. As you get up and move, the pain normally decreases, but it might return after long periods of standing or when you stand up after sitting.
- Causes: Plantar fasciitis is commonly caused by strain injury, causing micro-tears to the ligament as it attaches to the heel bone or other areas of tightness on the sole of the foot. Factors that can increase the risk include age, certain types of exercise (like long-distance running), foot mechanics, obesity, and occupations that keep you on your feet.
- Treatment: Most people who have plantar fasciitis recover with conservative treatments, including resting, icing the painful area, and stretching. Physical therapy, night splints, orthotics, and medications can also be beneficial.
2. Heel Spurs
Calcium deposits can be observed projecting in the shape of a bony hump from the underside of the heel bone. This bump can be identified by its white colour. Walking and standing might become excruciatingly uncomfortable as a result of them.
- Symptoms: While many people with heel spurs don’t experience any symptoms, some might feel pain or inflammation, especially during activities like walking or running.
- Causes: Heel spurs are often caused by strains on foot muscles and ligaments, stretching of the plantar fascia, and repeated tearing of the membrane that covers the heel bone. Risk factors include walking gait abnormalities, running on hard surfaces, and wearing poorly fitted or worn-out shoes.
- Treatment: Treatments for heel spurs are similar to those for plantar fasciitis. This includes physical therapy, shoe recommendations, orthotics, and medications. In persistent cases, surgical intervention might be considered.
Solutions and Treatments
- Proper Footwear: Ensure you wear shoes that provide adequate arch support and cushioning.
- Physical Therapy: Exercises and stretches can help alleviate pain and strengthen foot muscles.
- Rest and Ice: Taking breaks and applying ice can reduce inflammation.
- Orthotics: Custom-made inserts can provide additional support and cushioning.
- Medication: Over-the-counter pain relievers can help reduce pain and inflammation.
1. Footwear Adjustments
- Supportive Shoes: Opt for shoes that offer robust arch support and a cushioned sole. This is especially crucial for individuals who are on their feet for extended periods.
- Avoid High Heels: Regular use of high heels can strain the heel and arch of the foot. If necessary, limit their use and opt for lower, more comfortable heels.
- Replace Worn-Out Shoes: Shoes that have lost their cushioning and support can exacerbate heel pain. Regularly replace athletic shoes, especially if you’re an active individual.
2. Physical Therapies
- Stretching Exercises: Regularly stretching the Achilles tendon, calf muscles, and the plantar fascia can help alleviate and prevent pain.
- Strength Training: Building strength in the foot and calf muscles can provide better support and reduce strain on the heel.
- Massage: Gentle massage, especially with warm oil, can help in relaxing the muscles and tissues around the heel, providing relief from pain.
3. Orthotic Solutions
- Custom-made Orthotics: These are specially designed shoe inserts that provide additional support and cushioning, addressing specific foot biomechanics that might be causing heel pain.
- Heel Pads and Cups: These provide extra cushioning for the heel, reducing the impact and strain.
4. Medical Interventions
- Medication: Over-the-counter pain relievers like ibuprofen can help reduce pain and inflammation. Always consult with a healthcare professional before starting any medication.
- Corticosteroid Injections: For severe cases, a doctor might recommend injections to reduce inflammation and provide relief.
- Shock Wave Therapy: This non-invasive treatment uses sound waves to stimulate healing in the painful area.
5. Lifestyle Adjustments
- Weight Management: Reducing weight can significantly decrease the pressure on the heels, especially for overweight individuals.
- Rest and Ice: If you’ve had a particularly active day or if you notice swelling, resting and applying ice to the affected area can help reduce inflammation.
- Avoid Hard Surfaces: If possible, try to walk or stand on softer surfaces. If your job requires standing on hard surfaces, consider using a cushioned mat.
6. Surgical Options
In rare cases where non-surgical treatments don’t provide relief, surgery might be considered to address the underlying cause of the heel pain.
In conclusion, despite the fact that plantar heel pain can be uncomfortable, gaining an awareness of the factors that contribute to it and seeking therapy for the condition can help reduce the pain. It is imperative that you seek the advice of a podiatrist or other qualified medical practitioner for an accurate diagnosis if you are having persistent discomfort in your heel.