Jacquelin Ankrum

Respect your feet.

Heel Soreness

Overview

Pain In The Heel

Heel pain is a common foot condition. It's usually felt as an intense pain when using the affected heel. Heel pain usually builds up gradually and gets worse over time. The pain is often severe and occurs when you place weight on the heel. In most cases, only one heel is affected, although estimates suggest that around a third of people have pain in both heels. The pain is usually worse first thing in the morning, or when you first take a step after a period of inactivity. Walking usually improves the pain, but it often gets worse again after walking or standing for a long time. Some people may limp or develop an abnormal walking style as they try to avoid placing weight on the affected heel.

Causes

There are several causes of heel pain. By far the most common cause in adults is a condition commonly known as plantar fasciitis. Other names occasionally used for the same condition are heel spurs, and policeman?s heel. Plantar means bottom of the foot, and fascia is the fibrous tissues that helps tether the heel bone (calcaneus) to the heads of the metatarsal bones found at the base of your toes The meaning of ?itis? is inflammation. However, inflammation does not have a large part to play in the pathology, it is more degenerative (wear & tear) so the preferred title is plantar fasciosis or plantar aponeurotic fasciosis. For simplicity sake, we will refer to this common cause of heel pain as plantar fasciitis in this manual.

Symptoms

Pain typically comes on gradually, with no injury to the affected area. It is frequently triggered by wearing a flat shoe, such as flip-flop sandals. Flat footwear may stretch the plantar fascia to such an extent that the area becomes swollen (inflamed). In most cases, the pain is under the foot, toward the front of the heel. Post-static dyskinesia (pain after rest) symptoms tend to be worse just after getting out of bed in the morning, and after a period of rest during the day. After a bit of activity symptoms often improve a bit. However, they may worsen again toward the end of the day.

Diagnosis

Your doctor will listen to your complaints about your heel and examine you to see what is causing the pain, and whether anything else has started it off. If the cause of your pain seems obvious, your doctor may be happy to start treatment straight away. However, some tests may be helpful in ruling out other problems. Blood tests may be done for arthritis. An Xray will show any arthritis in the ankle or subtalar joint, as well as any fracture or cyst in the calcaneum. (It will also show a spur if you have one, but as we know this is not the cause of the pain.) Occasionally a scan may be used to help spot arthritis or a stress fracture.

Non Surgical Treatment

Once diagnosed, treatment for plantar fasciitis may include one or more of the following: advice on footwear, in particular use of arch-supportive footwear; avoid walking barefoot; stretching exercises, shoe modifications such as heel pads, taping and strapping, anti-inflammatories and orthotic devices to correct abnormal foot mechanics. Injection therapy with corticosteroids is only advisable if all the conservative treatment methods mentioned above have been exhausted due to undesired effects implicated with steroid infusion in the heels.

Surgical Treatment

Only a relatively few cases of heel pain require surgery. If required, surgery is usually for the removal of a spur, but also may involve release of the plantar fascia, removal of a bursa, or a removal of a neuroma or other soft-tissue growth.

heel cushion silicone

Prevention

Feet Pain

A variety of steps can be taken to avoid heel pain and accompanying afflictions. Wear shoes that fit well-front, back, and sides-and have shock-absorbent soles, rigid shanks, and supportive heel counters. Wear the proper shoes for each activity. Do not wear shoes with excessive wear on heels or soles. Prepare properly before exercising. Warm up and do stretching exercises before and after running. Pace yourself when you participate in athletic activities. Don?t underestimate your body's need for rest and good nutrition. If obese, lose weight.