Heel pain is the main reason people book in for an appointment with us.
We've been keeping track of the injuries and pain that our patients have been reporting, looking back into our text books and doing some research.
Our findings are that heel pain falls into one of five categories—and here are some tips to reassure you.
Plantar fasciitis
Nearly 90 percent of heel pain can be traced to an issue with the plantar fascia, the thick band of tissue that runs from under the heel to the toes and supports the arch.
Sometimes it's just a temporary inflammation. Other times it's a more chronic, degenerative condition—that worsens over time.
If you have the degenerative condition, your heel bones may develop a small offshoot of bone, called a heel spur. Heel spurs are the body's attempt to protect you from pain. So unless your heel spur is damaged, it's not causing the pain.
Trapped nerves
The medial calcaneal nerve runs through small tight tunnels. And if this nerve gets trapped it can lead to heel pain.
The nerve behind your ankle can also get trapped, which is commonly called tarsal tunnel syndrome.
We run a set of tests to accurately diagnose your condition. These may include tapping to check how well your nerves are functioning.
Stress fracture
For many heel injuries the best medicine is rest—is this foot hammock taking it too far?!
A much less common injury is getting a stress fracture in your heel bone. It's usually after high-impact exercise or an injury. It may be difficult to diagnose these small fractures—which are often very fine breaks.
In most cases, your bones will heal themselves if you treat them well, so our recommendation is to rest as much as possible and try to keep off your feet.
Achilles tendonitis
Achilles tendonitis means an inflamed Achilles tendon.
Its leading causes include:
- Overuse injury—which occurs when the Achilles tendon is stressed until it develops small tears. Runners are susceptible and also people who play sports that include jumping, such as basketball.
- Foot problems—such as flat feet or feet that turn inwards when you walk.
- Shoes—especially wearing shoes with little support when you run or walk, or wearing high heels.
Treatment includes avoiding the activities that caused the injury, being fitted for orthoses to ease the pressure while your foot is healing and changing your footwear.
We can give you advice about the kinds of shoes to wear.
Our treatment may also include iceing your injury and setting you a series of stretch, strength and balance exercises.
Unfortunately, it may take a while to recover from this injury, depending on how severe your injury has been and how well you follow the treatment and care instructions that we give you.
Heel fat pad disorder
Sometimes the fatty pad that surrounds your heel and acts as a shock absorber, can wear down or be injured.
It can feel like a deep, dull ache; like a bruise in the middle of your heel. And the pain gets worse if you walk on hard surfaces such as concrete or tiles.
One way of diagnosing your injury is taping. We will tape your foot to stabilise your heel—and then ask you to walk on a hard surface to see how it feels. If the pain is decreased or gone, then we have confirmed that it's probably fat pad syndrome.
Treatment may include a mix of taping, rest, "mobilising" or freeing up your joints and prescribing heel pads, heel cups or orthotics.
It's also a good idea to ice your heel after exercising, wear good cushioned shoes and avoid walking barefoot on hard surfaces.
