What is causing your heel pain?

July 1, 2018

Heel pain is frustrating – and that’s the mildest description of it that we hear from our patients on a regular basis. Heel pain, and foot pain generally, is one of those painful problems where you suddenly realise how much you’ve taken walking around pain-free for granted for your entire life. And it’s true – it’s a debilitating injury that impacts your whole day and ability to not just perform at your best, but also complete your everyday tasks and chores. It comes with no surprise that one of the first things that comes to mind when pain develops and you realise it’s not going away is: let’s consult Dr. Google. Despite Google’s numerous degrees, years of clinical experience and uncanny ability to assess and analyse your exact symptoms without even seeing or speaking to you, we thought we’d save you the ‘terminal’ diagnosis you’d otherwise stumble across and give you the most common causes of heel pain that we see here at Perform Podiatry daily.

1. Plantar Fasciitis

What is it? Plantar fasciitis is probably the most common cause of heel pain we see. It describes damage to, and inflammation of, the plantar fascia, a soft tissue band that runs from the bottom of your heel and fans out along the bottom of your foot to attach to your toes. You’re more likely to develop plantar fasciitis if you have a flatter foot type. What does it feel like? Plantar fasciitis is characterised by pain at the bottom (and for some toward the inside) of the heel which may radiate into the arch. Pain tends to be worse first thing in the morning and when standing after rest, though may ease after the first few minutes of walking. Some swelling may or may not be present.

2. Abductor Hallucis Tendinopathy

What is it? Abductor hallucis tendinopathy describes damage to the abductor hallucis muscle, which runs from the heel to the inside of the big toe. This cause of heel pain is often misdiagnosed as plantar fasciitis because it shares similar attachment points as the plantar fascia. Your abductor hallucis works in the movement of the big toe and helping to stabilise your foot as you walk. What does it feel like? The symptoms are similar to plantar fasciitis – everything from pain and tenderness at the bottom and inside of the heel to first step pain in the mornings and after rest. You may feel the pay through the arch and the border of the foot more with abductor hallucis tendinopathy compared to plantar fasciitis.

3. Achilles Tendinopathy

What is it? Achilles tendinopathy describes damage to the achilles tendon, the thick band that connects the muscles at the back of your leg to the back of your heel bone. The achilles tendon plays an important role in helping us walk and run, so this damage can make it more difficult to perform daily tasks. What does it feel like? Pain is generally present at the back of the heel, and can radiate up the back of the leg. Running (particularly uphill) and other physical activities will worsen the pain, and stiffness may be experienced at the back of the leg. Initially, there may be some swelling, but the pain can continue even when the swelling has subsided.

4. Sever’s Disease

What is it? Don’t worry, despite the name, sever’s disease is not really a disease, but a temporary condition present during stages of growth in kids. It describes the irritation of the growth plate located at the back of the heel. Growth plates are present in all growing bones and solidify once the bone has reached full maturity. Irritation and discomfort occur when strain and forces from surrounding muscles and tissues pull on the area around the growth plate. This is most common in active, growing kids between the ages of 8 and 15 years old. What does it feel like? Pain, tenderness and aches are felt at the bottom of the heel, usually during (and after) physical activity, particularly in running sports. The pain can range from sharp to dull and some swelling at the back of the heel may be present. The muscles at the back of the leg and heel may also feel tight.

5. Heel Fractures (Regular & Stress Fractures)

What are they? There are two types of fractures of note: regular fractures and stress fractures. Regular fractures are your standard fractures that you think of when a traumatic injury is sustained, like a tackle or jumping down from a high surface. It involves a break or crack(s) in the heel bone. A stress fracture, however, doesn’t usually involve an incident but builds up from repetitive activity and stress over time. This results in tiny cracks through the bone. What do they feel like? Regular fractures can cause sharp pain and aching at the heel. Stress fractures can range from mild, dull aches to sharp pain in the heel. In both cases, the heel can be very tender, may swell, and you may have trouble bearing weight/walking.

Other Causes

Of course, there are multiple other causes of heel pain. This can include skin conditions such as warts, corns, cracked heels and more. You may experience problems with the fat pad, which otherwise serves to protect the heel bone, but it can atrophy or become displaced. Nerve issues can also cause pain, alongside other neural problems such as numbness, tingling and pins and needles. This is where your Podiatrist will differentiate exactly what’s going on, the exact cause of your heel pain.

Treating Your Heel Pain

The trouble with heel pain is that you use your feet and heels to take every step, so it makes relieving pressure away from your feet so that the injury can heal significantly harder. This is why it’s important to see your Podiatrist so you can start recovering effectively. The sooner you start, the sooner you’ll get back to performing at your best and feeling great! Our team of foot health experts here at Perform Podiatry specialise in heel pain and help hundreds of people every year with these conditions alone. For more information or to make an appointment, you can give us a call on 09 523 2333 or book online here.