04 Sep What Causes Heel Pain?
Heel pain has a range of causes that need specific care and attention. Here are seven causes that our Masterton podiatrists see and treat.
Every day, we rely on the 28 bones, 33 joints, 112 ligaments, and 34 intrinsic and extrinsic muscles that control our feet to be able to take us anywhere we want to go. They help us cover as many kilometres as we need to, and stay stable over a range of challenging terrains – from our local (and epic) hiking trails to the hard concrete floors of many building sites for tradies or the bark-filled playgrounds with our kids. More than that, we expect our feet to stay comfortable and painless while also:
- Supporting our entire body weight on one foot during parts of the gait cycle, during every step (which is estimated to increase to up to three times our body weight during running)
- Helping to keep our entire bodies balanced and upright
- Absorbing shock and transferring ground reaction forces
- Adapting to any kind of shoe we put our feet in
With such large demands, it’s no surprise that at times, pain and injury can occur – and heel pain is one common area that this happens. While the term “heel pain” is often referred to as a diagnosis in and of its own, the reality is that there are many causes of heel pain, each with differences in the best way to treat them so you can get back to pain-free living.
Here’s a look into common causes of heel pain that our podiatrists see and treat.
Plantar Fasciitis
As the most common cause of heel pain that our podiatrists see and treat, plantar fasciitis means that a tissue called the plantar fascia has been damaged. Your plantar fascia is a thick, flat band of connective tissue that starts at the bottom and inside of the heel, and fans out across the arch to connect to all five toes. It plays a number of important roles in helping support your arch and the movement of your feet, thereby helping you walk efficiently.
When the plantar fascia is overloaded, it can sustain micro-tears and become damaged, inflamed and painful. This can cause significant pain to the bottom of the heel that may radiate into the arch. A tell-tale sign of plantar fasciitis is having sharp pain first thing in the morning, when you take your first steps, before easing somewhat.
Learn more about plantar fasciitis here.
Heel Spurs
A heel spur is a hard, bony, hook-like outgrowth at the bottom of the heel. A spur is a calcium deposit that builds up over many months, often developing in response to pressure or stress in the area, especially when ligaments are strained or tight. While it is estimated that 10% of the population have a heel spur, very few of these people (5% of those with heel spurs) will experience heel pain as a result of them. Most often, the pain is actually as a result of plantar fasciitis (above), because the two have the same causes.
Learn more about heel spurs here.
Achilles Injury
Your cord-like Achilles tendon is the strongest and largest tendon in your body, attaching to the back of your heel. When the Achilles is overloaded, overused or strained, damage can occur either at the mid-portion of the tendon or at its insertion. This can produce pain at the back of the heel during walking, running, and movements like standing on tip-toes.
Learn more about Achilles pain here.
Calcaneal Stress Fracture
A stress fracture is a type of bone fracture that occurs gradually over time, starting as tiny, asymptomatic micro-cracks in the bone that grow and worsen to become painful and limit daily activities. They are caused by overloading the heel and exposing the heel bone to excess forces over time, causing damage. As the pain associated with a calcaneal stress fracture comes on gradually and worsens, many people aren’t sure what has caused their pain as there isn’t a significant incident like there is with a regular fracture.
Learn more about stress fractures here.
Heel Pad Syndrome
We all have fat pads at the bottoms of our heels that play an important role in helping us absorb the pressure, shock and weight from every step we take. Whether it occurs naturally with age, or as a result of an injury or medical condition, our heel pads can wear down and no longer support and cushion our heels effectively. This can expose our heels to more pressure and stress, resulting in heel pain.
Bursitis
Bursitis means the inflammation of a bursa – a small, fluid filled sac that sits between structures in the body to help prevent painful friction and rubbing, while promoting lubrication and healthy movement. When the bursa is overloaded, like from excess pressure from tendons or other structures, it can become swollen and painful. This is known as bursitis. There are two bursae positioned at the back of the heel that can cause your heel pain – retrocalcaneal bursitis (the bursa between the Achilles tendon and the heel bone) and superficial calcaneal bursitis (sits just beneath the skin, at the back of the heel where the Achilles tendon inserts).
Learn more about bursitis here.
Sever’s Disease
Sever’s disease is a type of growing pain that only presents in children, often between ages 7-15 years. It is not a disease, but a growth-related condition occurring when the growth plate at the back of the heel is irritated or damaged. This irritation is most often from tension from the Achilles tendon, resulting in pain at the back of the heel. Growth plates are softer and more vulnerable areas to which new bone is added, meaning that they’re more vulnerable to injury. Children will typically experience pain during or after exercise which can range from mild to severe, and may limp as a result.
Learn more about Sever’s disease here.
How Can I Find Out What Is Causing My Heel Pain?
Unfortunately, there’s nothing online that can accurately diagnose the cause of a person’s heel pain because every person’s circumstances, medical and injury history, lifestyle factors and more, are unique, and must be assessed on a case-by-case basis. When this doesn’t happen is when we see people being treated for weeks or months for the wrong condition, wasting their time, money – and their physical and mental wellbeing.
We have a team of trusted podiatrists who are experienced in treating heel pain. Every assessment starts with a comprehensive exam so we can get to know everything from your medical history, to the what’s, how’s and why’s of your pain, to your lifestyle and personal circumstances – like whether you’re on your feet all day at work – to be able create a customised plan that you can gain the best results from. We have a range of evidence-based treatments and are here to support you at every step along the way.
Book your appointment with our Masterton podiatrists here.