Heel pain is one the most common problems seen by Pedorthists.
Causes of possible heel conditions:
- Poor foot mechanics,
- Being overweight
- Low activity levels
- Improper footwear
- Aging
- Unfavourable ground conditions
Examples of some common heel conditions include:
Plantar Fasciitis
One of the most common heel
problems, plantar fasciitis is
the inflammation and irritation of the plantar fascia (a thick fibrous
tissue that extends from the heel to the toes and supports the arch).
Poor foot posture or excessive ankle motion during walking can strain
the plantar fascia resulting in small tears and increased tension where
the fascia attaches to the heel bone.
Symptoms:
- Pain and swelling (inflammation) at the beginning of the arch or bottom of the heel
- Often the pain is worse with the first few steps when getting out of bed or after sitting
Calcaneal Stress Fracture
Calcaneal stress
fracture of the heel is usually a result of some sort of trauma but can
also result from increased activity done improperly.
Symptoms:
- Total avoidance of weight-bearing will be seen in an individual with a stress fracture of the calcaneus (heel).
Retrocalcaneal Bursitis (Achilles bursitis)
Retrocalcaneal bursitis is the inflammation of the bursa (balloon-like
lubricating sack) that lies between the Achilles tendon and the back of
the heel bone (calcaneus).
Symptoms:
- Tenderness is found at the back of the heel just above where the Achilles tendon attaches
- Swelling of the bursa produces symmetric widening of the heel where the Achilles tendon attaches to the calcaneus (heel)
- Pain increases with passive dorsiflexion (bending the foot towards the front of the leg) of the ankle or with standing on toes
Achilles Tendonopathy
Achilles tendonopathy is
an injury to the Achilles tendon just above the heel on the back of the
leg. This condition may be due to abnormal or excessive strain on the
tendon from poor shock absorption or excessive foot pronation.
Symptoms:
- Pain, swelling, and possible nodule formation along the Achilles tendon or where it is attached to the back of the calcaneus (heel)
- Stiffness may be present after sitting or resting
- Foot and lower limb exam
- Custom-made foot orthotic or over-the-counter device
- Recommendation of appropriate and proper-fitting footwear
- Modification of footwear
To prevent and alleviate heel pain, Canadian Certified Pedorthists recommend:
- Carefully and slowly increasing activity while allowing the tissues of the lower limb the time to properly adapt
- When injury does occur, consult a Canadian Certified Pedorthist to recommend the use of an over-the-counter device or a custom-made foot orthotic - along with appropriate footwear to help the healing process and to stop the recurrence of problems
- Selecting stable shoes with sturdy heel counters (the back of a shoe) that control motion or provide shock absorption as needed
- Avoid going barefoot or just wearing socks while injured as the poor mechanics of the foot can aggravate the injury further if not controlled.
- Icing and simple calf stretching can help alleviate pain associated with heel pain. Patients should ice the affected area for approximately eight minutes, three times a day.
