Every mile you walk puts tons of stress on each foot. Your feet can handle a heavy load, but too much stress pushes them over their limits. When you pound your feet on hard surfaces playing sports or wear shoes that irritate sensitive tissues, you may develop heel pain, the most common problem affecting the foot and ankle. A sore heel will usually get better on its own without surgery if you give it enough rest. However, many people ignore the early signs of Heel Pain and keep on doing the activities that caused it. When you continue to walk on a sore heel, it will only get worse and could become a chronic condition leading to more problems.
Heel pain has a number of causes that are typically associated with overuse of the heel bone. You can strain your heel by pounding your feet on hard surfaces, being overweight, or wearing shoes that do not fit properly. These strains can irritate the heel?s bones, muscles, or tendons. Other common causes of heel pain include the following. Heel Spurs. Heel spurs develop when the lining that covers the heel is continuously stretched. When this occurs, pieces of the lining may break off. Heel spurs typically develop in athletes who frequently run or jog. They are also common in people who are obese. Plantar Fasciitis. Plantar fasciitis develops when the tissue connecting the heel to the ball of the foot becomes inflamed. Plantar fasciitis also occurs in athletes who frequently run or jog. It can also result from wearing shoes that do not fit properly. Excessive Pronation. Excessive pronation occurs when the ligaments and tendons at the back of the heel are stretched too much. This condition can occur when injuries to the back, hips, or knees change the way you walk. Achilles Tendinitis. Achilles tendinitis can occur when the Achilles tendon, which runs along the back of the heel, becomes inflamed. This condition is common in people with active lifestyles who frequently run and jog, professional athletes and dancers.
Usually when a patient comes in they?ll explain that they have severe pain in the heel. It?s usually worse during the first step in the morning when they get out of bed. Many people say if they walk for a period of time, it gets a little bit better. But if they sit down and get back up, the pain will come back and it?s one of those intermittent come and go types of pain. Heel pain patients will say it feels like a toothache in the heel area or even into the arch area. A lot of times it will get better with rest and then it will just come right back. So it?s one of those nuisance type things that just never goes away. The following are common signs of heel pain and plantar fasciitis. Pain that is worse first thing in the morning. Pain that develops after heavy activity or exercise. Pain that occurs when standing up after sitting for a long period of time. Severe, toothache type of pain in the bottom of the heel.
Depending on the condition, the cause of heel pain is diagnosed using a number of tests, including medical history, physical examination, including examination of joints and muscles of the foot and leg, X-rays.
Non Surgical Treatment
Rest until there is no more pain. This is the most important element of treatment as continuing to walk or run on the injured foot will not allow the injury to heal. Wear soft trainers with lots of cushioning or pad the heel of shoes with shock absorbing insoles or heel pads. These should be worn in both shoes, even if only one heel is bruised. Wearing a raise in only one shoe causes a leg length difference which can cause other problems. Replace running shoes if they are old. A running shoe is designed to last for around 400 miles of running. After this the mid soles are weakened through use.
If treatment hasn't worked and you still have painful symptoms after a year, your GP may refer you to either an orthopaedic surgeon, a surgeon who specialises in surgery that involves bones, muscles and joints or a podiatric surgeon, a podiatrist who specialises in foot surgery. Surgery is sometimes recommended for professional athletes and other sportspeople whose heel pain is adversely affecting their career. Plantar release surgery is the most widely used type of surgery for heel pain. The surgeon will cut the fascia to release it from your heel bone and reduce the tension in your plantar fascia. This should reduce any inflammation and relieve your painful symptoms. Surgery can be performed either as open surgery, where the section of the plantar fascia is released by making a cut into your heel or endoscopic or minimal incision surgery - where a smaller incision is made and special instruments are inserted through the incision to gain access to the plantar fascia. Endoscopic or minimal incision surgery has a quicker recovery time, so you will be able to walk normally much sooner (almost immediately), compared with two to three weeks for open surgery. A disadvantage of endoscopic surgery is that it requires both a specially trained surgical team and specialised equipment, so you may have to wait longer for treatment than if you were to choose open surgery. Endoscopic surgery also carries a higher risk of damaging nearby nerves, which could result in symptoms such as numbness, tingling or some loss of movement in your foot. As with all surgery, plantar release carries the risk of causing complications such as infection, nerve damage and a worsening of your symptoms after surgery (although this is rare). You should discuss the advantages and disadvantages of both techniques with your surgical team.
Prevention of heel pain involves reducing the stress on that part of the body. Tips include. Barefeet, when on hard ground make sure you are wearing shoes. Bodyweight, if you are overweight there is more stress on the heels when you walk or run. Try to lose weight. Footwear, footwear that has material which can absorb some of the stress placed on the heel may help protect it. Examples include heel pads. Make sure your shoes fit properly and do not have worn down heels or soles. If you notice a link between a particular pair of shoes and heel pain, stop wearing them. Rest, if you are especially susceptible to heel pain, try to spend more time resting and less time on your feet. It is best to discuss this point with a specialized health care professional. Sports, warm up properly before engaging in activities that may place lots of stress on the heels. Make sure you have proper sports shoes for your task.