Having Heel Pain?

Many people have or had heel pain so you are not alone. Heel pain is usually the result of faulty biomechanics (walking gait abnormalities) that place too much stress on the heel bone and the soft tissues that attach to it. Fortunately heel pain can be improved and resolved if diagnosed and treated properly.

Most common cause: Plantar Fasciitis
These 2 words can be explained as the 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 causes pain and in more severe cases, causes growth of a bone spur where the fascia 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, such as frequent running and jumping.

Resting provides only temporary relief. When you resume walking, particularly after a night's sleep, you may experience a sudden elongation and irritation of the fascia band, which stretches and pulls on the heel bone. 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.

Inflammation of the plantar fascia

Heel Spurs ≠ Heel Pain
Heel spur is a bony growth on the underside of the heel. As stated above, severe plantar fasciitis may cause a growth of a bone spur, which may cause further heel pain. However, a recent study conducted in the United States revealed that having heel spur does not necessary cause heel pain. In the study, there were individuals who had x-ray evidences of heel spur but did not have any symptoms. Therefore in many cases, surgical excision of the bone spur aiming to relief heel pain may not be the most suitable treatment.

Other Causes of Heel Pain
Although plantar fasciitis is the most common cause of heel pain, there are numerous other conditions which can also lead to heel pain. Besides the bottom of the heel, pain can also be occurring on the back of the heel.

Bottom heel pain may also be a result of inflamed bursa or cyst (a sack of fluid), neuroma (a nerve growth), wearing poorly constructed shoes, or being overweight.

On the other hand, pain on the back of the heel may be due to Haglund’s deformity (a bony enlargement at the back of the heel bone), Achilles tendonitis (inflammation of the largest tendon of our body), shoe irritation, etc.

Other conditions such as Rheumatoid arthritis, Gout, Bone bruises or contusion, and less frequently, stress fractures, can lead to heel pain as well.

Don't just wear socks or go barefoot.You may try gentle calf stretches on each leg.
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 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."

When Should I see a doctor?
If heel pain and other symptoms of inflammation persist, such as redness, swelling, warmth in the area, you should limit normal daily activities and contact a foot and ankle specialist for evaluation and treatment.

Early treatment might involve appropriate stretching exercises, ice massage and shoe recommendations, taping or strapping. A functional shoes orthotic device may be prescribed for correcting biomechanical imbalance, controlling excessive pronation, and supporting of the ligaments and tendons attaching to the heel bone.

However, some cases of heel pain may require more advanced treatments such as night splint, oral anti-inflammatory medicine and/or corticosteroid injection.

Special Attention to Children having Heel Pain
Sometimes children between the ages of 8 and 13 become increasingly active in sports activities in and out of school. This physical activity, particularly jumping, inflames the growth centers of the heels which cause heel pain; the more active the child, the more likely the condition will occur. One should rest and avoid vigorous activity. Severe cases may need to be immobilized or even placed in a cast! If the heel pain is affecting your child’s activity, you should consult a foot and ankle specialist for further education about what can be done. Fortunately, when the bones mature, the problems usually disappear and are not likely to recur.

A variety of steps can be taken to avoid heel pain and accompanying afflictions:

Wear shoes that fit well – front, back, and sides.
Wear the proper shoes for each activity.
Shoes should have shock-absorbent soles, rigid shanks, and supportive heel counters.
Do not wear shoes with excessive wear on heels or soles.
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, losing weight can be the key to prevention.

This article was submitted by Dr. Gary Lam from California Foot and Ankle Medical Center. Dr. Lam has a Doctoral Degree in Podiatric Medicine and extensive medical and surgical experience in the United States. Feel free to call 2525-0611 for an appointment.

Do You Know?
The heel bone is the largest of the 26 bones in the human foot, which also has 33 joints and a network of more than 100 tendons, muscles, and ligaments. Both feet together there are 52 bones, which make up ¼ of the entire human skeleton!


home \| Temecula Valley \| Coachella Valley \| NCC San Diego \| Riverside-Corona \| Chicago \| Hong Kong \| franchise

Click a category above or search for a topic: × Close

Having Heel Pain? By: Dr. Gary K.Y. Lam, DPM Many people have or had heel pain so you are not alone. Heel pain is usually the result of faulty biomechanics (walking gait abnormalities) that place too much stress on the heel bone and the soft tissues that attach to it. Fortunately heel pain can be improved and resolved if diagnosed and treated properly. Most common cause: Plantar Fasciitis These 2 words can be explained as the 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 causes pain and in more severe cases, causes growth of a bone spur where the fascia 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, such as frequent running and jumping. Resting provides only temporary relief. When you resume walking, particularly after a night's sleep, you may experience a sudden elongation and irritation of the fascia band, which stretches and pulls on the heel bone. 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. Inflammation of the plantar fascia Heel Spurs ≠ Heel Pain Heel spur is a bony growth on the underside of the heel. As stated above, severe plantar fasciitis may cause a growth of a bone spur, which may cause further heel pain. However, a recent study conducted in the United States revealed that having heel spur does not necessary cause heel pain. In the study, there were individuals who had x-ray evidences of heel spur but did not have any symptoms. Therefore in many cases, surgical excision of the bone spur aiming to relief heel pain may not be the most suitable treatment. Other Causes of Heel Pain Although plantar fasciitis is the most common cause of heel pain, there are numerous other conditions which can also lead to heel pain. Besides the bottom of the heel, pain can also be occurring on the back of the heel. Bottom heel pain may also be a result of inflamed bursa or cyst (a sack of fluid), neuroma (a nerve growth), wearing poorly constructed shoes, or being overweight. On the other hand, pain on the back of the heel may be due to Haglund’s deformity (a bony enlargement at the back of the heel bone), Achilles tendonitis (inflammation of the largest tendon of our body), shoe irritation, etc. Other conditions such as Rheumatoid arthritis, Gout, Bone bruises or contusion, and less frequently, stress fractures, can lead to heel pain as well. What Should I do if I have Heel Pain? Don't just wear socks or go barefoot.You may try gentle calf stretches on each leg. 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 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." Example of calf stretching exercises When Should I see a doctor? If heel pain and other symptoms of inflammation persist, such as redness, swelling, warmth in the area, you should limit normal daily activities and contact a foot and ankle specialist for evaluation and treatment. Early treatment might involve appropriate stretching exercises, ice massage and shoe recommendations, taping or strapping. A functional shoes orthotic device may be prescribed for correcting biomechanical imbalance, controlling excessive pronation, and supporting of the ligaments and tendons attaching to the heel bone. However, some cases of heel pain may require more advanced treatments such as night splint, oral anti-inflammatory medicine and/or corticosteroid injection. Special Attention to Children having Heel Pain Sometimes children between the ages of 8 and 13 become increasingly active in sports activities in and out of school. This physical activity, particularly jumping, inflames the growth centers of the heels which cause heel pain; the more active the child, the more likely the condition will occur. One should rest and avoid vigorous activity. Severe cases may need to be immobilized or even placed in a cast! If the heel pain is affecting your child’s activity, you should consult a foot and ankle specialist for further education about what can be done. Fortunately, when the bones mature, the problems usually disappear and are not likely to recur. Can Heel Pain be Prevented? A variety of steps can be taken to avoid heel pain and accompanying afflictions: Wear shoes that fit well – front, back, and sides. Wear the proper shoes for each activity. Shoes should have shock-absorbent soles, rigid shanks, and supportive heel counters. Do not wear shoes with excessive wear on heels or soles. 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, losing weight can be the key to prevention. (Source: American Podiatric Medical Association) This article was submitted by Dr. Gary Lam from California Foot and Ankle Medical Center. Dr. Lam has a Doctoral Degree in Podiatric Medicine and extensive medical and surgical experience in the United States. Feel free to call 2525-0611 for an appointment. *Do You Know?* The heel bone is the largest of the 26 bones in the human foot, which also has 33 joints and a network of more than 100 tendons, muscles, and ligaments. Both feet together there are 52 bones, which make up ¼ of the entire human skeleton!