The function of the heel in walking is to absorb the shock of your foot striking the ground as it is put down and to start springing you forward on the next step. It contains a strong bone (the
calcaneum). Under the bone are a large number of small pockets of fat in strong elastic linings, which absorb much of the shock (fat pads). The heel is attached to the front of the foot by a number
of strong ligaments which run between the front part of the calcaneum and various other parts of the foot. The strongest ligament is the plantar fascia, which attaches the heel to the toes and helps
to balance the various parts of the foot as you walk. It therefore takes a lot of stress as you walk. In some people the plantar fascia becomes painful and inflamed. This usually happens where it is
attached to the heel bone, although sometimes it happens in the mid-part of the foot. This condition is called plantar fasciitis and causes Heel Pain
Plantar fasciitis: It is the most common cause of heel pain. In this condition, the pain is more severe in the morning but becomes less painful as the day continues. It occurs due to tiny tears in
the plantar fascia.The plantar faschia is a tissue band that connects the bottom of the heel bones to the ball of the foot and is involved in walking and running, giving spring to the step. If left
untreated, the symptoms usually worsen and can lead to problems with the knee and hip and can cause back pain due to difficulty walking. Those who frequently stand or walk throughout the day or those
who run are most likely to develop plantar fasciitis.
Both heel pain and heel spurs are frequently associated with an inflammation of the long band of tissue that connects the heel and the ball of the foot. The inflammation of this arch area is called
plantar fasciitis. The inflammation maybe aggravated by shoes that lack appropriate support and by the chronic irritation that sometimes accompanies an athletic lifestyle. Achilles Tendinopathy, Pain
and inflammation of the tendon at the back of the heel that connects the calf muscle to the foot. Sever?s, Often found in children between the ages of 8 - 13 years and is an inflammation of the
calcaneal epiphyseal plate (growth plate) in the back of the heel. Bursitis, An inflamed bursa is a small irritated sack of fluid at the back of the heel. Other types of heel pain include soft tissue
growths, Haglunds deformity (bone enlargement at the back of the heel), bruises or stress fractures and possible nerve entrapment.
The diagnosis of heel pain and heel spurs is made by a through history of the course of the condition and by physical exam. Weight bearing x-rays are useful in determining if a heel spur is present
and to rule out rare causes of heel pain such as a stress fracture of the heel bone, the presence of bone tumors or evidence of soft tissue damage caused by certain connective tissue disorders.
Non Surgical Treatment
There are many treatments for fasciitis. The most common initial treatment provided by the family doctor are anti-inflammatory medications. They may take the edge off the pain, but they don't often
resolve the condition fully. Steroid injections, which deliver the medication directly to the most painful area, are usually more effective. Rest, ice, weight loss, taping, strapping, immobilization,
physiotherapy, massage, stretching, heel cushions, acupuncture, night splints and extra-corporeal shock wave therapy all help some patients. Many patients, however, have a biomechanical cause such as
excessively pronated feet to their complaint, and this may mean many of the treatments listed above will only provide temporary relief of fasciitis symptoms. When you stop the treatment, the pain
often returns. This is why many cases of fasciitis respond well to orthoses, custom-made inserts that control the mechanical cause of the complaint. If you're considering orthoses, it's very
important to have a podiatrist specializing in the field to examine you. There are many biomechanical factors to consider when assessing the need for literally dozens of types of devices available,
so you need to have an expert to properly assess you. (Unfortunately, as is the case in many jurisdictions, there is no minimum standard of training required in British Columbia to make orthoses, and
there are many fly-by-night operations around that employ salesmen with little, if any, training in understanding anatomy or foot function. The emphasis with these groups is on selling you some sort
of device, rather than providing proper assessment, treatment and follow-up.
At most 95% of heel pain can be treated without surgery. A very low percentage of people really need to have surgery on the heel. It is a biomechanical problem and it?s very imperative that you not
only get evaluated, but receive care immediately. Having heel pain is like having a problem with your eyes; as you would get glasses to correct your eyes, you should look into orthotics to correct
your foot. Orthotics are sort of like glasses for the feet. They correct and realign the foot to put them into neutral or normal position to really prevent heel pain, and many other foot issues.
Whether it be bunions, hammertoes, neuromas, or even ankle instability, a custom orthotic is something worth considering.
Flexibility is key when it comes to staving off the pain associated with these heel conditions. The body is designed to work in harmony, so stretching shouldn?t be concentrated solely on the foot
itself. The sympathetic tendons and muscles that move the foot should also be stretched and gently exercised to ensure the best results for your heel stretches. Take the time to stretch thighs,
calves and ankles to encourage healthy blood flow and relaxed muscle tension that will keep pain to a minimum. If ice is recommended by a doctor, try freezing a half bottle of water and slowly
rolling your bare foot back and forth over it for as long as is comfortable. The use of elastic or canvas straps to facilitate stretching of an extended leg can also be helpful when stretching
without an assistant handy. Once cleared by a doctor, a daily regimen of over-the-counter anti-inflammatory medication like Naproxen Sodium will keep pain at bay and increase flexibility in those
afflicted by heel pain. While this medication is not intended to act as a substitute for medical assessments, orthopedics or stretching, it can nonetheless be helpful in keeping discomfort muted
enough to enjoy daily life. When taking any medication for your heel pain, be sure to follow directions regarding food and drink, and ask your pharmacist about possible interactions with existing
medications or frequent activities.