By Alex Bigale, PTA
Causes of Heel Pain
The human body is designed to handle the high amounts of stress that we place on each day. This is particularly true about the foot and heel. The heel is the largest bone in the foot, composed of 26 bones, ligaments, tendons, muscle, and fascia. These components are designed to handle the stress of standing, walking, jumping, and running, but sometimes you can experience pain in the heel due to multiple different factors.
What are Causes of Heel Pain?
There are many causes for heel pain. Below are 5 common causes of heel pain:
- Impact on the Heel (stone bruise)- A sudden hard impact of the heel can cause damage the bone itself or the underlying fat pad. This usually occurs when a person falls or jumps from an elevated surface. Repetitive impacts can also cause pain, such as running/jumping on hard surfaces (concrete) while wearing footwear that is not properly supported. These repetitive impacts are often referred to as “heel pain syndrome.”
- Heel Spurs– A small growth of bone can occur on the heel’s bottom side, which will cause pain and possible damage to the tissue surrounding the heel due to pressure and rubbing.
- Plantar Fasciitis– This is inflammation of the band of connective tissue that runs under the heel and connects to the ball of the foot. This disorder is common in people who participate in running and jumping activities for exercise. Stress on the heel from chronic plantar fasciitis can be a cause of heel spurs develop.
- Excessive Pronation- Heel pain caused by poor biomechanics with walking or running. This most commonly occurs with excessive pronation. Pronation is a movement that the foot can make to adapt to ground surfaces and absorb impact. When a person pronates their foot too much, it causes stress to the ligaments and tendons attached to the heel’s backside. This can also attribute to knee, hip, or back pain.
- Achilles Tendonitis- The Achilles tendon connects the muscles of the calf to the heel. It’s common for runners to have tight tendons, which, over time, can lead to stress and small tears in the tendon. This causes inflammation and pain on the backside of the heel. Chronic tendonitis can lead to a bone spur on the heel.
Treatments for Heel Pain
If symptoms such as pain, swelling, redness, and tenderness persist, you should schedule an appointment with either a podiatrist or orthopedic physician, even with rest and icing. Most causes of heel pain can be treated with conservative measures. Your physician will typically perform an x-ray to rule out damage to the bone. Depending on the source of the pain, they will try a variety of things such as:
- oral anti-inflammatories
- steroid injections
- a walking boot
- physical therapy
If you are interested in trying orthotics for heel pain, read about Footmaxx, JOI’s custom prescription orthotics.
Stretches & Exercises for Heel Pain
Once physician decides to prescribe physical therapy, you will be evaluated by a physical therapist. Your physical therapist will create a care plan for you with specific stretches and exercises. Theses activities are aimed to reduce pain and provide stability for the foot/ankle to prevent future injuries. Listed below are stretches and exercises that can help your heel pain.
Stretches for Heel Pain
The following stretches should be performed for 30 seconds, 3 times.
Start by standing in front of a wall or other sturdy object. Step forward with one foot and maintain your toes on both feet to be pointed straight forward. Keep the leg behind you with a straight knee during the stretch. Lean forward towards the wall and support yourself with your arms as you allow your front knee to bend until a gentle stretch is felt along the back of your leg that is mostly behind you.
Start by standing in front of a wall or other sturdy object. Step forward with one foot and maintain your toes on both feet to be pointed straight forward. Keep the leg behind you with a bent knee during the stretch. Lean forward towards the wall and support yourself with your arms. Allow your front knee to bend until a gentle stretch is felt along the back of your leg that is mostly behind you.
Great Toe Extension Stretch
While seated, cross your legs so that the affected leg is on top. Next, bend your big toe back with your fingers until a stretch is felt in your toe and or bottom of your foot.
Exercises for Heel Pain
Frozen Water Bottle/Lacrosse Ball Roll
Perform either sitting or standing. Place your affected foot on the bottle/ball. Roll your foot forward and backward for 2-3 minutes.
While seated, place your foot on a towel. Scrunch your toes to pull the towel towards you. Perform 3 sets of 10 scrunches.
Seated Calf/Toe Raises
While seated, push your heels up and then let them come back to the ground. Perform this for 2 minutes. Then, pull your toes up towards you and let them go back to the ground in the same position. Perform 2 minutes as well.
Standing Calf Raises on a Step
Stand with the balls of your feet on the edge of a step. Lower heels just below the level of the step (you may feel a stretch), then raise your heels, so you are standing on your toes. Perform 3 sets of 10 reps.
When is Surgery Required for Heel Pain?
Most physicians or surgeons will exhaust all conservative measures before trying surgery. If you have a fracture of the heel bone or a torn tendon/ligament that is causing your pain, then surgery may be indicated sooner.
By: Alex Bigale, PTA
Whether you are suffering from heel issues, joint pain, or injuries resulting from any activity, JOI has 12 physical therapy clinics conveniently located in Jacksonville and Northeast FL that specialize in orthopedic rehab.
If you are interested in scheduling an appointment at JOI Rehab for physical therapy, schedule online, click below or call (904) 858-7045. Come see us!