Did you know that every mile you walk puts approximately 60 tons of stress on each one of your feet? They may be able to take a heavy load, but they still have limits. And often, heel pain is how they tell you they’ve had enough.
Heel pain is a common problem. It can occur for various reasons, but it can be a result of putting too much stress on this part of your body — often from overtraining during sports. Additional causes of heel pain include:
- Being overweight or obese
- Running or jumping a lot
- Spending long periods on your feet, especially on hard surfaces
- Wearing shoes that don’t fit properly or provide proper support
- Long term use of stiff shoe inserts/arch supports
- Having flat feet, high arches, or arthritis in the foot and ankle
Our team at ROC diagnoses and treats heel pain on a regular basis at each of our locations in Tualatin and Oregon City, Oregon. Here are four causes of heel pain that we see most often, and how we can help.
1. Plantar fasciosis (a more appropriate term than Plantar fasciitis)
More than 3 million people suffer from plantar fasciosis each year, making it the leading cause of heel pain. This condition develops when the connective tissue (fascia) running along the bottom of your foot becomes stretched, or torn on a microscopic level. Dr. Feinblatt wrote a book chapter on this subject. (Sports Injuries of the Foot: Evolving Diagnosis and Treatment, Terrence M. Philbin, ed. 2014)
In most cases, plantar fasciosis pain occurs under the heel pad. It often seems mild in the beginning, but can flare as time goes on. It tends to be at its worst first thing in the morning, with your first steps after prolonged rest.
2. Achilles tendinosis (a more appropriate term than Tendonitis)
If you have aching above your heel or in the back of your leg after exercise, or stiffness in this area first thing in the morning, it could be Achilles tendinosis. This painful condition impacts the tissue connecting the calf muscle in your lower leg to your heel bone.
Achilles tendinosis is most common is frequently seen in middle-aged “weekend warriors” — or those who play sports just a few days per week, and may not be properly conditioned for the intensity of their periodic sports activities.
3. Haglund’s deformity
This is a prominent bump caused by the contour of your heel bone. With time, it can become more symptomatic. You may notice difficulty wearing shoes with a backing (heel counter). This can cause local swelling (a bursitis), as well as eventual deterioration of the Achilles tendon. There are several treatment options for Haglund’s deformity and the resulting issues, but in general, steroid injections should be avoided.
4. Heel stress fractures
Last but not least, stress fractures involving the heel are another common cause of persistent heel pain. Unlike a break that occurs from a traumatic blow like a car accident, these fine fractures occur because of long-term, repetitive stress that finally leaves a hairline crack in the bone. They can be associated with a sudden increase in physical activity, or low Vitamin D levels.
Heel stress fractures usually cause intense pain that makes walking difficult. While you should always seek treatment for heel pain that disrupts your daily life, it’s even more crucial if it involves a fracture; untreated stress fractures can lead to further damage and complications.
Treating heel pain
We offer numerous treatments for heel pain, depending on the underlying cause of your symptoms. In general for these conditions we do not suggest steroid injections, as these can further weaken soft tissues and lead to continued issues. After performing a comprehensive evaluation and reaching a diagnosis, we could recommend a variety of therapies, such as:
- Rest and activity modification
- Temporary immobilization
- Exercise programs to stretch and strengthen soft tissues
- Platelet-rich plasma (PRP) injections
Some types of damage or conditions that have not responded to other treatments may require surgery to correct the problem. Since 2008, we have been performing minimally invasive surgery when appropriate to correct these problems. You can rest easy knowing that our team has extensive experience with these procedures. And, since they’re minimally invasive, you can expect them to come with less post-op pain, fewer risks, and faster recovery times.