Heel Pain

Heel pain is generally 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. The stress may also result from injury, or a bruise incurred while walking, running, or jumping on hard surfaces; wearing poorly constructed footwear; or being overweight.
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. Like all bones, it is subject to outside influences that can affect its integrity and its ability to keep us on our feet. Heel pain, sometimes disabling, can occur in the front, back, or bottom of the heel.


Prevention 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.

Treatment
Initial treatment involves managing symptoms and biomechanical control. Non-steroidal anti-inflammatories or steroid injections, if used alone, usually do not provide long term relief.

  • Changes in shoe gear
  • Functional orthotics are a vital part of treatment, especially when biomechanical abnormalities are present.
  • Taping and bracing, particularly during athletic activity
  • Physical therapy
If conservative treatment fails to provide relief or the ankle is too unstable to be controlled with bracing and orthotics, surgical treatment is warranted. Surgical correction is based upon the presenting condition and varies from simple repair of ruptured ligaments to complex reconstruction of ligaments with tendon grafts and osteochondral repair of a damaged articular surface.

More information
You can also download our Podiatry-at-a-Glance newsletters: A Guide to Heel Pain (Heel Spur Syndrome).