There are lots of different reason as to why you might be suffering from heel pain. Heel pain really isn’t something to be shrugged off as if it is left untreated it can get worse and turn into a chronic condition. Heel pain requires a thorough examination and treatment by different specialists (orthopaedic surgeon, rheumatologist, physioptherpists) to find the underlining cause of the heel pain and treat them.
Causes of heel pain
The most common cause of heel pain is plantar fasciitis and/or heel spurs, but there are other possible causes.
- Heel pain can sometime be triggered by continuous over stretching of the structures of the foot. BAD NEWS IF YOU ARE A HIGH HEEL LOVER. Sorry to all of the wishful thinkers out there but high heels do damage your feet. Full stop. Wearing high heels for a long period of time leads to overstretched tissues of the foot causing damage to the foot and heel leading to pain.
- Heel pain can arise as a consequence of the thinning of the fat on the sole of the foot and around the heel area, making your heel more sensitive to pressure and shock.
- Heel pain can also be caused by pressure building up underneath your heels due to standing on hard surfaces and being on your feet for long periods of time.
- Obesity or a rapid increase in body weight (pregnancy) can put more strain on the tendons and ligaments found in your foot leading to heel and foot pain.
In this article we will be focusing on the most common cause of heel pain, plantar fasciitis!
Recent studies have shown that at least 10% of people will suffer from plantar fasciitis at least once in their life. Most often, plantar fasciitis will have an effect on athletes and runners but is also quite common amongst the ageing population as well. In most cases of plantar fasciitis, people will only get one sore heel however it is not uncommon for both feet to be affected. Heel pain is usually the most severe in the morning or when the first steps after sleeping. As the day progresses heel pain may lessen, but come back again after a long walk or through over stretching the feet.
Plantar fasciitis treatments
Typically, plantar fasciitis is treated using a whole range of different treatments ranging from wearing orthotic insoles, stretching exercises that are all designed to eithier strengthen the ligaments in your feet or correct biomechanical imbalances with maybe causing the plantar fasciitis (Read our great article about the different biomechanical issues that can cause plantar fasciitis here.).For Immediate pain relief painkillers and anti inflammatory drugs can also used to help reduce pain and reduce inflammation . Treatment can be a long drawn out process and it may in some instances take up to a year for plantar fasciitis to fully heal.
Stretches for plantar fasciitis
Stretching exercises for the calf muscles and the Plantar fascia helps ease pain and boost the flexibility of your feet. It is advised that you carry out the exercises with both feet, even if only one of your feet has plantar fasciitis.
Stretching your feet on a Chair. Whilst sitting on a chair bend your knees at right angles. Expand the foot so that both your heels touch each other, and the toes are pointed in opposite directions. Slowly lift the your toes whilst gently pressing your heel to the floor. You should feel the the stretch in the calf muscles and Achilles tendon. Stay in this position for a few seconds, then relax. Repeat 10 times, and do this stretch 6-7 times a day.
Stretching using towels. In the morning, just after getting out of bed, loop a towel around your foot and pull the toes on upwards, keeping the knee straight. Repeat this stretch three times a day on each leg.
Stretching from the walls. Place your hands flat onto a wall at shoulder level, placing one foot in front of the other. The front foot must be placed around 30 cm away from the wall. Keeping your back straight, then, bend the front leg at the knee, leaning against the wall until you feel the tension of the calf muscle of the other legs. Repeat 10 times on one foot, then the same on the other foot. You should try to do this stretch at least twice a day..
Stretching on the stairway. Stand on a step, facing the stairs. Make sure that your feet are just a little bit apart, with your heel hanging a slightly over the step. Lower your heels until you feel a stretch on your calf muscles. Stay in this position for about 30 seconds, then return to the starting position. You should repeat this stretch six times on each leg.
Avoid wearing ill fitting shoes!
Walking in ill fitting and unsupportive shoes for a long periods can often causes pain in the heel. Narrow and unsupportive shoes with heels that are too high or no heels may contribute to overload of the heel when walking, and undue strain and inflammation to the feet. Shoes that have flat soles can also cause unnatural positioning of the foot and can also cause pain in the heel. You should therefore avoid shoes with a high heel, as well as shoes with flats soles. Remember, your Shoes should be made from high quality materials, that are rigid and provide enough support the foot and leg. If you do not fancy buying a new pair of shoes wearing orthotic insoles that secure the foot in correct position can be just as good for your feet!
Orthotics slip into your existing shoes to help keep the foot in correct position and absorb shock when walking. Orthotic insoles can be bought online and are relatively inexpensive. The whole idea of orthotic insoles is to correct the overall function of your foot by correcting biomechanical problems such as over pronation and under pronation that can contribute to excessive strain on the sole and heel. Sometimes the a physiotherapist may tell you to wear custom made insoles that will be specially made to fit your feet. However, there is no real evidence that shows that expensive custom insoles are better for your feet than off the shelf insoles. Here at Shoewawa we have a wide range of excellent shoe insoles specially designed for plantar fasciitis that will help you get back on your feet in no time. Check out our range here.
Some doctors recommend using special night splints that you can wear on your feet whilst you sleep. Most people whilst sleeping point their toes downwards, causing the Plantar fascia to shorten. This can cause people who suffer from plantar fasciitis to suffer from severe pain in the morning when bearing weight on their shortened plantar fascia in the morning.
Night splints are deigned to point the toes and foot upwards whilst you sleep. This helps to stretch the Achilles tendon and Plantar fascia allowing torn ligament fibres to be in the correct position and speeds up their recovery. You can buy night splints on the internet.
Pain killers and ice can help reduce inflammation and pain. To ease pain you can take non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. Applying ice wrapped in a towel to the sore heel for 5-10 minutes can also help to relieve pain and inflammation. If you do not have ice handy a bag of peas works just as well!.
If the above treatments do not help ease your heel pain, a doctor may suggest corticosteroid injections. Corticosteroid injections are strong anti-inflammatory drugs which ought to be used with care because these drugs can have severe side effects such as weight gain and high blood pressure. For these reasons, Corticosteroid injections should
not be taken more than three times a year!
Surgery (AKA the last resort)
If non of the treatments listed above have helped and after a year you still have pain, surgery might be required. Sometimes surgery is preferred by professional athletes and runners, if the heel pain is having a negative impact on their sporting careers.
Plantar fascia excision operation – is the most traditionally used type of surgery when it comes to plantar fasciitis. In this procedure the surgeon will remove the fascia by cutting and separating it from the calcaneus. Removing the plantar fascia should get rid of the inflammation and ease pain.
As with any surgical procedure there are risks such as infection, nerve damage and worsening heel and foot pain that can arise.
Shock wave therapy for heel spurs
This is a fairly new non-invasive and non surgical treatment. Shock-wave therapy is quite successful in cases whereby the heel pain cause by a heel spur. Shockwave therapy is when high-energy sound pulses are aimed at the heel with special equipment. Shockwave therapy can be quite painful, so a doctor will genrally inject a local anaesthetic into the patients foot.
Now that we know how to treat heel pain.. how do you go about preventing it?
As the old saying goes prevention is cheaper than the cure and where heel pain is concerned this is definitely true!
Completely preventing heel pain is is almost impossible, however, having said that you can take steps to prevent future foot rpoblems and heel pain. Being obses can contribute to excessive strain on the foot, particluarly on the heel, potentially causing damage. If you are obese or overweight, weight loss and preserving a normal body weight by through regular exercise and with healthy balanced diet can keep you healthy and help to prevent foot and heel pain!
If you are serious about preventing heel pain wearing the “correct” choice of footwear is essential. If you wear high heels to a party, it is not likely to hurt, however if you wear your high heels the whole week at work, it can easily damage the foot, particularly if you have an active life style and do a lot of walking or stand around for long periods of time in your high heels. It more ideal to wear lace-up shoes that have a low or medium heel, as well as shoes that provide your feet with adequate arch support and protects feet and heels from shock. Do not wear shoes with flat soles, you have been warned!
Do not walk on hard surfaces such a the pavement barefoot. Heel pain frequently arises when a someone begins walking barefoot or in sandals on holiday. If all year you have been walking around in shoes and then to suddenly change your footwear to sandals your feet will not accustomed to this sudden change in footwear which can cause additional pressure to the feet that your feet are not used to.
Make sure to regularly change your shoes. If you lead an active lifestyle, for example, you run or play a lot of sports your shoes may become worn out and will not be able to properly support your feet as they used to. Most specialists advise people to change sports shoes after you have ran about 800 km in them.
Be sure to do stretching exercises after exercising, as well as include regular exercise on strength and flexibility in your workout.
If you have any questions please do not hesitate to ask in the comments section below or even in our forum! Thanks for reading.