Heel Pain

“I can’t put my foot down 1^st thing in the morning without severe pain.”  “By the end of the day, my heels are just achy and the bottom of my feet are burning.”  “I can’t go for long walks because my heels hurt.”  Sound familiar? 

Sharp pain, aching or stiffness on the bottom of one or both heels is a very common ailment.  In the beginning, pain is usually the worst 1^st thing in the morning, with after some walking, tends to subside.  Then, as the day goes on, the pain and discomfort tends to return.  Even after resting, the first few steps upon rising can be uncomfortable. 

This heel pain arises deep within the foot and actually is caused by inflammation and tearing of a thick, broad ligament attached to the heel bone, called the plantar fascia.  The posterior calf muscles manifest themselves in the Achilles tendon which goes around the heel to become the thick, broad ligament (plantar fascia) which goes from the heel to the forefoot.  The plantar fascial ligament supports : the 4 layers of muscles on the bottom of the foot; the bones of the foot; and helps to create the arch.   

The biomechanical action of the muscles, bones and tendons of the foot can create a tension in the ligament which it cannot withstand.  The ligament becomes irritated, inflamed and tears away from the heel or down the middle.  This tearing creates the inflammation which results in pain.  If the ligament tears away enough, a bone spur can form on the heel.

The majority of heel pain is caused by the genetic structure of a person’s foot involving their bones, muscles and tendons.  Both high arched and low arched people can develop plantar fasciitis.  Other causes of heel pain include : major health problems as high/low thyroid; diabetes; arthritis; collagen disorders; tumors or nerve injuries.

Treatments for heel pain include stretching, icing, taping, injections, physical therapy, non-steroidal anti-inflammatory and orthotics.  In controlling the biomechanics of the way someone walks, using a custom moulded orthotics, the majority of people eliminate their heel pain.  In stopping the motion which causes the tearing of the ligament, the symptoms resolve.  However, a small percentage of people (approx. 2%), do not respond to conservative measures and require surgical intervention.  

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