Question 1

Heel Spurs

Accepted Answer

A common cause of heel pain is the heel spur, a bony growth on the underside of the heel bone. The spur, visible by X-ray, appears as a protrusion that can extend forward as much as half an inch. When there is no indication of bone enlargement, the condition is sometimes referred to as "heel spur syndrome."
 
Heel spurs result from strain on the muscles and ligaments of the foot, by stretching of the long band of tissue that connects the heel and the ball of the foot, and by repeated tearing away of the lining or membrane that covers the heel bone. These conditions may result from biomechanical imbalance, running or jogging, improperly fitted or excessively worn shoes, or obesity.

Question 2

Plantar Fasciitis

Accepted Answer

Both heel pain and heel spurs are frequently associated with an inflammation of the band of fibrous connective tissue (fascia) running along the bottom (plantar surface) of the foot, from the heel to the ball of the foot. The inflammation is called plantar fasciitis. It is common among athletes who run and jump a lot, and it can be quite painful.
 
The condition occurs when the plantar fascia is strained over time beyond its normal extension, causing the soft tissue fibers of the fascia to tear or stretch at points along its length. This leads to inflammation, pain, and possibly the growth of a bone spur where it attaches to the heel bone.
 
The inflammation may be aggravated by shoes that lack appropriate support, especially in the arch area, and by the chronic irritation that sometimes accompanies an athletic lifestyle.
 
Resting provides only temporary relief. When you resume walking, particularly after a night's sleep, you may experience a sudden elongation of the fascia band, which stretches and pulls on the heel. As you walk, the heel pain may lessen or even disappear, but that may be just a false sense of relief. The pain often returns after prolonged rest or extensive walking.

Question 3

Excessive Pronation

Accepted Answer

Heel pain sometimes results from excessive pronation. Pronation is the normal flexible motion and flattening of the arch of the foot that allows it to adapt to ground surfaces and absorb shock in the normal walking pattern.
 
As you walk, the heel contacts the ground first; the weight shifts first to the outside of the foot, then moves toward the big toe. The arch rises, the foot generally rolls upward and outward, becoming rigid and stable in order to lift the body and move it forward. Excessive pronation, or excessive inward motion, can create an abnormal amount of stretching and pulling on the ligaments and tendons attaching to the bottom back of the heel bone. Excessive pronation may also contribute to injury to the hip, knee, and lower back.

Question 4

Disease and Heel Pain

Accepted Answer

Some general health conditions can also bring about heel pain. Rheumatoid arthritis and other forms of arthritis, including gout, which usually manifests itself in the big toe joint, can cause heel discomfort in some cases.
 
Heel pain may also be the result of an inflamed bursa (bursitis), a small, irritated sack of fluid, a neuroma (a nerve growth), or other soft-tissue growth. Such heel pain may be associated with a heel spur or may mimic the pain of a heel spur.
 
Haglund's deformity ("pump bump") is a bone enlargement at the back of the heel bone, in the area where the Achilles tendon attaches to the bone. This sometimes-painful deformity generally is the result of bursitis caused by pressure against the shoe and can be aggravated by the height or stitching of a heel counter of a particular shoe.
 
Pain at the back of the heel is associated with inflammation of the Achilles tendon as it runs behind the ankle and inserts on the back surface of the heel bone. The inflammation is called Achilles tendinitis. It is common among people who run and walk a lot and have tight tendons. The condition occurs when the tendon is strained over time, causing the fibers to tear or stretch along its length, or at its insertion on to the heel bone. This leads to inflammation, pain, and the possible growth of a bone spur on the back of the heel bone. The inflammation is aggravated by the chronic irritation that sometimes accompanies an active lifestyle and certain activities that strain an already tight tendon.
 
Bone bruises are common heel injuries. A bone bruise or contusion is an inflammation of the tissues that cover the heel bone. A bone bruise is a sharply painful injury caused by the direct impact of a hard object or surface on the foot. Stress fractures of the heel bone also can occur, although infrequently.

Question 5

Prevention

Accepted Answer

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.

When Should You Seek Professional Help?
If pain and other symptoms of inflammation, such as redness, swelling, heat, persist, you should limit normal daily activities.
 
Early treatment might involve oral anti-inflammatory medication, exercise and shoe recommendations, taping or strapping, or use of shoe inserts or orthotic devices. Taping or strapping supports the foot, placing stressed muscles and tendons in a physiologically restful state. Physical therapy may be used in conjunction with such treatments.
 
A functional orthotic device may be prescribed for correcting biomechanical imbalance, controlling excessive pronation, and supporting of the ligaments and tendons attaching to the heel bone. It will effectively treat the majority of heel and arch pain without the need for surgery. Only a relatively few cases of heel pain require more advanced treatments or surgery.

Question 6

Heel Pain Tips

Accepted Answer

If you have experienced painful heels, try wearing your shoes around your house in the evening. Don't wear slippers or socks or go barefoot. You may also try gentle calf stretches for 20 to 30 seconds on each leg. This is best done barefoot, leaning forward towards a wall with one foot forward and one foot back.
If the pain persists longer than one month, you should visit a foot specialist for evaluation and treatment. Your feet should not hurt, and professional care may be required to help relieve your discomfort.
If you have not exercised in a long time, consult your foot specialist before starting a new exercise program.
Begin an exercise program slowly. Don't go too far or too fast.
Purchase and maintain good shoes and replace them regularly.
Stretch each foot and the Achilles tendon before and after exercise.
Avoid uneven walking surfaces or stepping on rocks as much as possible.
Avoid going barefoot on hard surfaces.
Vary the incline on a treadmill during exercise. Nobody walks uphill all the time.
If it hurts, stop. Don't try to "work through the pain".
Ice the area by rolling a frozen water bottle under the foot for a 20-minute duration.
Roll a tennis ball under your foot prior to rising from bed in the morning to help stretch the muscles and tendons.

Stoney Creek Foot Health & Orthotic Centre

Foot Conditions We Treat in Stoney Creek

Heel Pain

Heel Spurs

Plantar Fasciitis

Excessive Pronation

Disease and Heel Pain

Prevention

Heel Pain Tips

Plantar Fasciitis

Symptoms

What Causes Plantar Fasciitis?

Additional Information on Plantar Fasciitis

Do You Have Plantar Fasciitis?

Arthritis

Arthritis and the Feet

Symptoms

Some Forms of Arthritis

Diagnosis

Treatment

Morton's Neuroma

Definition

Signs and Symptoms

Diagnosis and Treatment

Diabetes

Symptoms

How Do You Get Diabetes?

The Role of Your Foot Specialist

Wound Healing

If You Have Diabetes

Toenail Fungus

Other Conditions We Treat

1. Skin and Nail Conditions

2. Musculoskeletal and Biomechanical Conditions

3. Structural and Deformity Conditions

4. Diabetic Foot Conditions

5. Neurological Conditions Affecting the Foot

6. Vascular Conditions

7. Sports and Activity-related Injuries

8. High-risk and At-risk Foot Care

9. Conditions Frequently Managed with Orthotics

10. Conditions Requiring Minor Surgical Procedures

What Our Clients Are Saying

Do You Have Questions?

Stoney Creek Foot Health & Orthotic Centre