may develop when you pound your feet on hard surfaces playing sports or wear
shoes that irritate sensitive tissues. A sore heel will usually get better on its own if you give it enough rest. Unfortunately, many people try to ignore the early signs of heel pain and keep on
doing the activities that caused it and this can lead to chronic pain. Conditions that cause heel pain generally fall into two main categories: pain beneath the heel and pain behind the heel. Pain
beneath the Heel. If it hurts under your heel, you may have one or more conditions that cause inflammation of the tissues on the bottom of your foot. Stone bruise. By stepping on a hard object, you
can bruise the fat pad on the bottom side of your heel. It may or may not look discoloured. With rest, the pain subsides gradually.
Plantar Fasciitis is the most common form of heel pain. The tears and inflammation that develop along the plantar fascia ligament result in dull aching pain or a burning sensation along the bottom of
the foot. Pain becomes particularly noticeable after periods of rest, such as during the first few steps after getting out of bed in the morning, or after getting up after a prolonged period of
sitting. Another common form of heel pain is the development of a heel spur. A heel spur, as mentioned above, is the formation of a bony hook extending from the heel. Typically, these growths develop
near the area where the plantar fascia connects to the heel bone. The repetitive pressure on the plantar fascia that results from stretching excessively away from the heel bone causes a response from
our body that delivers calcium to the area. The heel pain that ensues develops from the nerves and sensitive tissue that become irritated when the bone fragment digs into the bottom of the heel. Pain
may decrease after walking as the tissue in the heel gets used to the fragment and adjusts around it. However, pain will be particularly problematic following periods of rest. Strained muscle tissue
may cause heel pain in several areas. A tight plantar fascia causes additional tension, particularly while exercising, placing runners and other athletes at risk if the ligament is not properly
warmed up prior to exercise. Additionally, a tight Achilles tendon along the back of the foot can also add tension along the plantar fascia, resulting in possible damage, not to mention the damage
and pain that can occur along the Achilles tendon itself (Achilles tendonitis). It is recommended that athletes properly stretch the foot as well as the calf in order to reduce tension on muscle and
other tissue in the foot.
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.
In most cases, your GP or a podiatrist (a specialist in foot problems and foot care) should be able to diagnose the cause of your heel pain by asking about your symptoms and medical history,
examining your heel and foot.
Non Surgical Treatment
Most heel pain is caused by a combination of poor biomechanics, or muscle weakness or tightness. The good news is that heel pain can be effectively managed once the cause is identified. Most heel
pain can be successfully treated via pain and pressure relief techniques, biomechanical correction eg orthotics, taping, foot posture exercises, muscle stretches and massage, lower limb muscle
strengthening, proprioceptive and balance exercises to stimulate your foot intrinsic muscles. If you feel that your footwear or sports training schedule are potentially causing your heel pain, then
we recommend that you seek the advice of a sports physiotherapist, podiatrist or trained footwear specialist (not just a shop assistant) to see if your shoe is a match for your foot; or discuss your
training regime to see if you are doing too much. Heel pain and injury are extremely common. With accurate assessment and early treatment most heel pain injuries respond extremely quickly to
physiotherapy allowing you to quickly resume pain-free and normal activities of daily living. Please ask you physiotherapist for their professional treatment advice.
Although most patients with plantar fasciitis respond to non-surgical treatment, a small percentage of patients may require surgery. If, after several months of non-surgical treatment, you continue
to have heel pain, surgery will be considered. Your foot and ankle surgeon will discuss the surgical options with you and determine which approach would be most beneficial for you. No matter what
kind of treatment you undergo for plantar fasciitis, the underlying causes that led to this condition may remain. Therefore, you will need to continue with preventive measures. Wearing supportive
shoes, stretching, and using custom orthotic devices are the mainstay of long-term treatment for plantar fasciitis.
Heel pain is commonly caused from shoes that do not fit properly. In addition, shoes need to have ample cushioning and support, particularly through the heel, ball of the foot, and arch. Shoes should
also be replaced if they become too worn. One sure sign of wear and tear is overly worn areas of a shoe's insoles. If the heel or ball of the foot is particularly worn, damage could easily occur
since the bottom of the foot is not getting the cushioning it needs.