WHY DOES YOUR HEEL HURT?
By: Sara John, C.Ped (C)., C.Ped Tech (C)
Heel pain is a common symptom that can affect anyone from excessive stress on the feet. Our feet composed of many bones, joints, ligaments, tendons, and tissues take a lot of pounding when standing all day at work, or enjoying the daily run. They can withstand a lot of demands, but can easily be injured by the way we walk or by using ill-fitting shoes.
One of the most common causes of heel pain is Plantar Fasciitis - inflammation of plantar fasciia. Plantar fasciia is the tightly wrapped thick connective tissue that runs in the arch of the foot and maintains the arch by binding the bones, ligaments, muscles and other tissues together.
Plantar fasciitis develops when the arch of the foot drops repetitively and causes stretching of the fasciia resulting in micro-tears. The thinnest and weakest part of the fascia is where it attaches at the front of the heel bone (calcaneus) which makes it vulnerable to damage. People with high arches experience large degrees of foot drop when weight bearing whereas people with low arches or flat feet pronate causing their feet to roll inwards leading to lot of wear on the fasciia.
The classic symptom is heel pain when you take your first steps after getting out of bed or after sitting for a long period of time. When the foot is in a resting position and while sleeping, the body starts mending the torn tissues. With the first step, the mended micro-tear gets re-torn under body weight which gives the sharp shooting pain. This eventually subsides to a dull ache, or it might decrease to some extent after a person has had time to loosen up and become fully engaged in an activity.
Standing for several hours on a hard surface, running too much or too hard, wearing improperly fitting shoes, being overweight, pregnancy, and unusual tightness in the feet or legs- all these can result in plantar fasciitis.
Heel spurs are painful hooks of bone on the heel usually seen associated with plantar fasciitis.
Another common cause of heel pain is tarsal tunnel syndrome, which occurs when a large nerve in the back of the foot becomes pinched, similar to carpal tunnel syndrome in the hand.
Stress fractures of the bone in the heel can also cause pain.
If the person has inability to walk comfortably on the affected foot, pain that occurs at night or while resting, pain that persists beyond few days, swelling or discoloration, or any signs of infection require medical attention.
Treatment options for heel pain include icing, elevating and resting the feet, changing to better fitting shoes to help absorb shock, off the shelf or custom made orthotics to support the foot during weight-bearing to prevent arch collapse, night splints, stretching and pain medications. If left untreated, it can lead to changes in the way a person walks and create other painful problems in the body.
